Retinal Assessment and the Retina-Choroid Link in Precapillary Pulmonary Hypertension: A Single-Center...

Area of Science:

• Ophthalmology
• Cardiology
• Medical Imaging

Background:

• Systemic microvascular remodeling is a known complication of precapillary pulmonary hypertension (PPH).
• The relationship between the outer retina and choroid in PPH patients is not well understood.

Purpose of the Study:

• To evaluate macular retinal thickness and choroidal structure in PPH patients.
• To investigate the association between the outer retina and choroid in PPH.
• To compare PPH patients with healthy controls.

Main Methods:

• A single-center cross-sectional study involving 29 PPH patients and 37 controls.
• Enhanced depth imaging spectral-domain optical coherence tomography (EDI-SD-OCT) was used.
• Quantification of retinal layers (total retina, inner retina, outer nuclear layer (ONL), outer retinal layer (ORL), retinal pigment epithelium (RPE)) and choroidal thickness, including macular choroidal vascularity index (mCVI).

Main Results:

• PPH patients showed reduced total macular thickness, ORL thickness, RPE thickness, and central choroidal thickness compared to controls.
• Outer retinal layer (ORL) thickness was positively correlated with choroidal thickness and negatively with mCVI in PPH patients.
• ORL thickness effectively differentiated PPH patients from controls (AUC 0.818).

Conclusions:

• Precapillary pulmonary hypertension is associated with outer retinal and choroidal thinning.
• A unique outer retina-choroid structural association exists in PPH patients.
• Outer retinal layer thickness may serve as an adjunct structural indicator for PPH.