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Updated: Jul 29, 2025

Evaluation of Capillary and Other Vessel Contribution to Macular Perfusion Density Measured with Optical Coherence Tomography Angiography
Published on: February 18, 2022
Retinal vascular density change in patients with heart failure
Caner Topaloglu1, Sinan Bekmez2
1Department of Cardiology, Izmir University of Economics, Izmir, Turkey.
Insights
Heart failure (HF) patients exhibit reduced retinal microvascular density, particularly in the deep capillary plexus, compared to healthy individuals. OCT-A imaging reveals significant changes in retinal perfusion among HF patients, correlating with disease severity.
Area of Science:
- Ophthalmology
- Cardiology
- Medical Imaging
Background:
- Heart failure (HF) is a complex syndrome affecting cardiovascular and systemic microcirculation.
- Optical coherence tomography angiography (OCT-A) offers non-invasive visualization of retinal microvasculature.
Purpose of the Study:
- To evaluate choroid thickness and retinal vessel density in superficial and deep capillary plexuses in HF patients using OCT-A.
- To compare these parameters between HF patients of varying severity and healthy controls.
Main Methods:
- OCT-A imaging was performed on 36 healthy participants and 33 HF patients (LVEF <50%).
- HF patients were stratified into two groups based on NYHA classification (Group 2 and Group 3).
- Choroid thickness, superficial, and deep capillary plexus perfusion were analyzed and compared across groups.
Main Results:
- A significant decrease in choroid thickness was observed in HF groups compared to controls.
- Superficial capillary plexus density showed no significant difference between HF groups and controls, but decreased in NYHA Class III patients.
- Deep capillary plexus density significantly decreased in NYHA Class III patients and showed significant differences among HF groups.
Conclusions:
- HF patients demonstrate reduced retinal microvascular density compared to healthy controls.
- Significant alterations in retinal perfusion exist among HF patients, varying with disease severity.
- OCT-A assessment of retinal perfusion may provide insights into the hemodynamic status and microcirculatory changes in HF.
Purpose:
The aim of this study is to assess choroid thickness, retinal vessel density in the superficial capillary plexus layer and deep capillary plexus layer in heart failure (HF) using optical coherence tomography angiography (OCT-A).
Methods:
36 healthy participants (group 1), 33 patients with HF were assessed for this study. HF patients had a left ventricular ejection fraction (LVEF) <50%. HF patients were divided into 2 groups according to the New York Heart Association (NYHA). 15 patients were evaluated as group 2 according to NYHA and 18 patients as group 3 according to NYHA. Choroid thickness, superficial and deep capillary plexus perfusion were analyzed between groups using OCT-A.
Results:
Choroid thicknesses were found to be significantly decrease in the HF groups. Superficial capillary plexus density was compared with the control group, no statistically significant difference was found between the HF groups. But among the HF groups, a statistically significant decrease was found in group 3 patients. Deep capillary plexus density was compared with the control group, a statistically significant decrease was found in group 3. In addition, deep capillary plexus density a statistically significant difference was found between the groups HF.
Conclusions:
Patients with HF showed decreased flow density compared with healthy controls. In addition, significant changes were found in flow densities among the HF groups. Retinal perfusion measured using OCT-A may give an idea about the hemodynamic status and microperfusion of HF patients.
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