The alterations of retinal vasculature detected on optical coherence tomography angiography associated with chronic obstructive pulmonary disease

Abstract

Objectives This study aimed to evaluate the retinal vasculature of the macula and optic disc in patients with chronic obstructive pulmonary disease (COPD) by optical coherence tomography angiography (OCTA). Methods The right eyes of 70 COPD patients and 71 healthy individuals were evaluated. These patients had moderate airflow limitation and mean PO2 of 60 mmHg, and their average age was less than 60 years. Superficial and deep capillary plexus vascular densities, foveal avascular zone (FAZ) width, and optic disc parameters were measured with OCTA. In addition, the correlation between the PO2 level in COPD patients and superficial, deep, and peripapillary vascular densities and FAZ was examined in the study. Results The COPD group had a significant decrease in the vascular density in the superficial (fovea [p = 0.019]; parafovea [p = 0.013]; and perifovea [p = 0.001]) and deep capillary plexus (fovea [p = 0.028]; parafovea [p = 0.005]; and perifovea [p = 0.002]). Also, the enlargement of the FAZ (p = 0.002) and a decrease in the peripapillary vascular density (p = 0.006) were observed in the COPD group. There was a positive correlation between PO2 level and superficial, deep, and peripapillary vascular densities in COPD patients and a negative correlation with FAZ (r = 0.559–0.900). Conclusion Hypercapnia, respiratory acidosis, and chronic hypoxia associated with COPD may affect the macula and optic nerve, resulting in a serious decrease in vascular density, and OCTA can be a very important tool in the follow‐up and treatment of these patients.

Retinal microvascular changes in patients recovered from COVID-19 compared to healthy controls: A meta-analysis

“…A possible explanation for the vulnerability of the DCP in ischemia could be the distance from the bigger retinal arteries and the proximity to the outer retina which has bigger metabolic requirements due to the photoreceptors and retinal pigment epithelium's activity. In addition, patients that suffer from chronic obstructive pulmonary disease or sleep apnea syndrome have been found to have decreased retinal VD, implying that oxygenation plays an important role in macular microvascular damage [ 36 , 37 ].…”

Optical coherence tomography angiography as a surrogate marker for end-organ resuscitation in sepsis: A review

“…In addition to reporting retinal blood flow alterations in systemic disease ( 29 , 30 , 33 – 35 ), Kannenkeril et al also indicate that OCTA changes are associated with disease progression in CKD ( 31 ), showing promise as a marker of disease severity in other systemic disorders affecting the microcirculation. Coppolino et al ( 32 ) found an association between pre-dialysis retinal VD and patients who subsequently experienced intradialytic hypotension, demonstrating prognostic value and concluding that OCTA could stratify the short-term risk of this complication.…”

“…Patients with chronic obstructive pulmonary disorder (COPD) had reduced retinal vascular density compared with healthy controls in the superficial and deep capillary plexi on OCTA ( p = 0.002) ( 35 ). COPD patients also had a larger FAZ diameter than healthy participants ( p = 0.002) ( 35 ), and there was a moderate correlation between partial pressure of oxygen (pO 2 ) and superficial/deep vascular density ( r = 0.559/0.800 respectively), and a highly negative correlation between pO 2 and FAZ size ( r = −0.876) ( 35 ), suggesting that retinal vascular density by OCTA may be useful to monitor disease progression in COPD patients ( 35 ). Retinal imaging in COPD has also shown that older age, higher systolic BP and lower levels of systemic inflammation are associated with narrower retinal venules ( p < 0.05) ( 36 ).…”