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Ocular perfusion in patients with reduced left ventricular ejection fraction measured by optical coherence tomography angiography

  • Retinal Disorders
  • Published:
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Abstract

Aims

The aim of this study is to evaluate retinal and optic nerve head (ONH) perfusion in patients with systolic chronic heart failure (CHF) compared to healthy control subjects.

Methods

Twenty-seven eyes of 27 patients with CHF (study group) and 31 eyes of 31 healthy subjects (control group) were prospectively included in this study. CHF Patients had a left ventricular ejection fraction (LVEF) < 50% and were classified by New York Heart Association (NYHA) class. OCT-A was performed using RTVue XR Avanti with AngioVue (Optovue, Inc, Fremont, CA, USA). The area of the foveal avascular zone (FAZ) and flow density (FD) data were extracted and analyzed.

Results

There was no significant difference in the signal strength index between the study group (group 1) and the control group (group 2) (ONH: p = 0.015; macula: p = 0.703). The difference in the area of the foveal avascular zone between the two groups was also not significant (p = 0.726). The flow density (whole en face) in the ONH (RPC) in group 1 was significantly lower compared to control (group 1 = 48.40 ± 2.48 (49.0 [46.7, 50.3]); group 2 = 50.15 ± 1.85 (50.6 [48.5, 51.70]); p = 0.008). There was a significant and strong correlation between LVEF and the macular flow density (whole en face) (superficial: rs = 0.605 deep: rs = 0.425, p < 0.01).

Conclusions

Patients with CHF showed reduced flow density compared with healthy controls. The reduced FD correlated with the LVEF and the functional (NYHA) class. Retinal perfusion as measured using OCTA might provide an insight into the global microperfusion and hemodynamic state of heart failure patients.

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Author notes

  1. Maged Alnawaiseh, Franziska Eckardt, Larissa Lahme and Philipp Sebastian Lange contributed equally to this study.

Authors and Affiliations

  1. Department of Ophthalmology, Klinikum Fulda gAG, Hospital Fulda, University of Marburg, Campus Fulda, Fulda, Germany

    Maged Alnawaiseh & Natasa Mihailovic

  2. Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany

    Maged Alnawaiseh, Franziska Eckardt, Natasa Mihailovic, Raphael Diener, Friederike Rosenberger, Nicole Eter & Larissa Lahme

  3. Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany

    Gerrit Frommeyer, Lars Eckardt & Philipp Sebastian Lange

Authors
  1. Maged Alnawaiseh
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  2. Franziska Eckardt
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  3. Natasa Mihailovic
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Corresponding author

Correspondence to Maged Alnawaiseh.

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This article does not contain any studies with animals performed by any of the authors.

All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Alnawaiseh, M., Eckardt, F., Mihailovic, N. et al. Ocular perfusion in patients with reduced left ventricular ejection fraction measured by optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 259, 3605–3611 (2021). https://doi.org/10.1007/s00417-021-05253-6

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  • DOI: https://doi.org/10.1007/s00417-021-05253-6

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