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Subfoveal choroidal thickness and retinal nerve fiber layer alterations in chronic heart failure patients
Hatice Selen Kanar1, Aysegul Penbe1, Batur Gonenc Kanar2
1Department of Ophthalmology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Health Science University, Istanbul, Turkey.
Insights
Chronic heart failure patients showed reduced subfoveal choroidal thickness compared to controls. Peripapillary retinal nerve fiber layer thinning was observed only in severe heart failure patients with reduced left ventricle ejection fraction.
Area of Science:
- Ophthalmology
- Cardiology
Background:
- Chronic heart failure (CHF) is associated with systemic complications.
- Ocular microvascular changes may reflect systemic vascular health.
Purpose of the Study:
- To compare subfoveal choroidal thickness (SFCT) and peripapillary retinal nerve fiber layer (RNFL) thickness in CHF patients versus controls.
- To assess the correlation of these ocular parameters with left ventricle ejection fraction (LVEF) in CHF.
Main Methods:
- Spectral domain-optical coherence tomography (SD-OCT) was used to measure SFCT and RNFL thickness.
- Seventy-two CHF patients (Group 1: 30-50% LVEF; Group 2: <30% LVEF) and 40 controls were included.
Main Results:
- SFCT was significantly lower in both CHF groups compared to controls.
- RNFL thickness was significantly lower in Group 2 (<30% LVEF) compared to controls and Group 1.
- No significant difference in RNFL was found between Group 1 and controls.
Conclusions:
- Reduced SFCT is associated with CHF, regardless of ejection fraction severity.
- RNFL thinning is specifically linked to severely reduced LVEF (<30%) in CHF patients.
- These ocular findings may aid in monitoring chorioretinal health and glaucoma risk in CHF.
Purpose:
To comparatively evaluate the subfoveal choroidal thickness and the peripapillary retinal nerve fiber layer thickness in patients with chronic heart failure relative to control subjects.
Methods:
A total of 72 chronic heart failure patients and 40 healthy control subjects were enrolled in this study. The patients were categorized into 2 groups: group 1: patients with 30-50% left ventricle ejection fraction and group 2: patients with the corresponding fraction value of <30%. The subfoveal choroidal thickness and the peripapillary retinal nerve fiber layer thickness were measured by spectral domain-optical coherence tomography.
Results:
The mean subfoveal choroidal thickness was 250.24 ± 68.34 µm in group 1 and 216.72 ± 71.24 µm in group 2, while it was 273.64 ± 77.68 µm in the control group. The differences among the 3 groups were statistically significant. The average peripapillary retinal nerve fiber layer thicknesses were 100.34 ± 8.24, 95.44 ± 6.67, and 102.34 ± 8.24 µm, respectively. No significant differences were noted in the peripapillary retinal nerve fiber layer thicknesses between group 1 and control group, but it was significantly lower in group 2.
Conclusion:
Our study thus revealed that the subfoveal choroidal thickness was lower in patients belonging to both the chronic heart failure groups in comparison to those in the control group. However, the alteration in the peripapillary retinal nerve fiber layer thickness was noted in only patients with <30% left ventricle ejection fraction. In the clinical practice, reductions in these values are correlated with decreased left ventricle ejection fraction, which may be important for the follow-up of chorioretinal diseases and the evaluation of glaucoma risks in patients with chronic heart failures.
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