Key result
Patients with heart failure with reduced ejection fraction had significantly lower subfoveal choroidal thickness (264 vs 313 μm) and reduced parafoveal superficial retinal vascular density compared to healthy controls.
Why the study?
Alterations of choroidal and retinal microvasculature in patients with HFrEF compared with normal age and sex-matched population were not well characterized.
Are there alterations in choroidal and retinal microvasculature in patients with HFrEF compared to healthy controls?
Cross-Sectional (n=58)
No
Are there alterations in choroidal and retinal microvasculature in patients with HFrEF compared to healthy controls?
Patients with HFrEF exhibit structural and microvascular alterations in the retina and choroid, specifically reduced subfoveal choroidal thickness and parafoveal superficial capillary plexus vascular density.
Answers are grounded in this paper and cite their sources.
Retinal OCT may detect microvascular changes in HFrEF; hypothesis-generating and should not change practice without prospective validation.
This cross-sectional study was designed to assess alterations of choroidal and retinal microvasculature in patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and compare them with a normal age and sex-matched population. Fifty-two eyes of 26 patients with HFrEF (left ventricular ejection fraction [LVEF] < 40%) and 64 eyes of 32 healthy individuals were considered as the patient and the control groups, respectively. We found no statistically significant differences in age-adjusted mean central macular thickness (CMT), superficial or deep retinal capillary plexus vascular densities, and choriocapillaris flow (CC flow) density between the HFrEF group and the normal controls, with the exception of the parafoveal mean superficial capillary plexus vascular density (P = 0.023), which remained statistically significant after adjusting for age (P = 0.034). The patients with HFrEF had a significantly lower subfoveal choroidal thickness (SFCT) than the normal subjects (264 ± 82 vs 313 ± 72; P = 0.009), and the difference was still statistically significant after age adjustment (P = 0.026). Although choroidal vascularity index (CVI) was lower in the HFrEF group than in the control group, the difference was not statistically significant before and after age adjustment (73.45 ± 6.67 vs 75.77 ± 5.92; P = 0.118 and P = 0.096, respectively). In conclusion, in patients with HFrEF, we observed a reduction in parafoveal retinal VD in the superficial capillary plexus, as well as SFCT, but no significant change in CVI, CMT, or CC flow density.
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Khalilipur et al. (2023) conducted a cross-sectional in Heart Failure with Reduced Ejection Fraction (HFrEF) (n=58). Heart Failure with Reduced Ejection Fraction (HFrEF) vs. Healthy individuals was evaluated on Subfoveal choroidal thickness (SFCT) (MD -38.842, 95% CI -73.073 to -4.610, p=0.009). Patients with heart failure with reduced ejection fraction had significantly lower subfoveal choroidal thickness (264 vs 313 μm) and reduced parafoveal superficial retinal vascular density compared to healthy controls.
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