Cardio-ocular syndrome: Retinal microvascular changes in acutely decompensated heart failure

Area of Science:

• Ophthalmology
• Cardiology
• Medical Imaging

Background:

• Acute decompensated heart failure (ADHF) is a critical condition affecting cardiovascular function.
• Retinal microvasculature alterations may reflect systemic hemodynamic changes.
• Contemporary imaging techniques like OCT-A offer novel insights into microvascular dynamics.

Purpose of the Study:

• To investigate dynamic changes in retinal microvasculature during ADHF.
• To compare retinal microvasculature in ADHF patients with healthy controls.
• To assess the reversibility of these changes after cardiac recompensation.

Main Methods:

• Adult patients hospitalized with ADHF underwent comprehensive eye examinations, including OCT and OCT-A, within 24 hours of admission and before discharge.
• Transthoracic echocardiography and biomarker analysis (NT-proBNP) were performed.
• A control group of age-matched individuals without cardiac or retinal disease was included for comparison.

Main Results:

• ADHF patients exhibited impaired visual acuity, reduced macular vessel density, and altered perfusion density upon admission compared to controls.
• A significant increase in the diameter of the superior temporal retinal vein was observed in ADHF patients.
• Following treatment and recompensation, retinal microvascular density and perfusion significantly improved, and retinal vein diameter normalized.

Conclusions:

• Acute decompensated heart failure induces reversible changes in the retinal microvasculature.
• OCT-A is a valuable tool for assessing microperfusion and hemodynamic status in ADHF patients.
• These findings highlight the potential of ocular imaging in managing heart failure.