Glaucomatous optic nerve head alterations in patients with chronic heart failure

Abstract

Video abstract Video

Evaluation of retinal vessel caliber, choroidal thickness, and ocular perfusion pressure in patients with low cardiac ejection fraction

“…The IOP values were also found to be similar in both groups. In contrast to our results, Meira-Freitas et al [17] reported that chronic heart failure was associated with lower IOP, whereas similar to our results, Altinkaynak et al [5] found no significant difference in the IOP measurements between the heart failure patients and healthy controls.…”

Abnormal vascular regulation in the ophthalmic artery of chronic heart failure patients

“…CHF patients presented lower blood flow velocities and higher resistance index in ophthalmic artery when compared to control group. Our research group also reported that CHF is associated with glaucomatous optic nerve head changes that correlate with ocular perfusion pressure (OPP) and echocardiographic parameters (2) . Herein, we expand on these findings and show the relationship between OPP and blood flow parameters of ophthalmic artery in CHF patients.…”

“…According to this pathophysiology, patients with CHF could theoretically be exposed to hemodynamic changes in ocular microcirculation and have an increased risk for developing glaucoma. In fact, previous study have shown an association between CHF and glaucomatous optic nerve head alterations (2) . In conclusion, the abnormal relationship between resistance index of ophthalmic artery and OPP corroborates to the hypothesized vascular mechanism of the reported glaucomatous optic nerve head alterations in CHF patients.…”

Association between Chagas disease and changes in the optic nerve and retinal nerve fiber layer

“…The mean VCDR standard deviation identified in a previous study was used to estimate that 39 individuals in each group would be required to have a power of 80% (alpha= 5%) to detect a 0.1 difference in the VCDR between the groups. A standard deviation of 0.19 was considered in the case group and 0.15 in the control group, an intracluster correlation between both eyes of the same subject of 0.85, and a significance level of 0.05% (7) .…”

“…Autonomic nervous system (ANS) involvement, characteristic of the chronic phase of Chagas disease, was reported in studies showing abnormal pupillary responses to diluted pilocarpine and intraocular pressure (IOP) postural variability (5,6) . In the chronic phase of the disease, chronic heart failure (CHF) occurs in some chagasic patients and may be involved in alterations of the optic nerve (ON) and retinal nerve fiber layer (RNFL) (7) .…”