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Ocular microvascular alterations in patients with heart failure with preserved ejection fraction

Yoichiro Shinohara1, Masaru Obokata2, Ryo Mukai3,4

  • 1Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa machi, Maebashi, Gunma, 371-8511, Japan. shinohara@gunma-u.ac.jp.

Japanese Journal of Ophthalmology
|May 30, 2026
PubMed

Insights

Ocular blood flow and retinal thickness are reduced in heart failure with preserved ejection fraction (HFpEF) patients. These changes correlate with cardiac function, suggesting LSFG and OCT/OCTA can detect HFpEF-related ocular alterations.

Area of Science:

  • Ophthalmology
  • Cardiology
  • Medical Imaging

Background:

  • Heart failure with preserved ejection fraction (HFpEF) affects cardiac function.
  • Ocular circulation may reflect systemic cardiovascular health.

Purpose of the Study:

  • To investigate ocular circulation and structure in HFpEF patients.
  • To assess the association between ocular findings and cardiac function in HFpEF.

Main Methods:

  • Prospective observational study of 15 HFpEF patients and 15 controls.
  • Evaluated best-corrected visual acuity (BCVA), retinal and choroidal thickness, laser speckle flowgraphy (LSFG), and optical coherence tomography angiography (OCTA).
  • Echocardiography assessed cardiac function, including E/e' for diastolic dysfunction.

Main Results:

  • Reduced mean blur rate (MBR) in optic nerve head (ONH) and macula in HFpEF patients.
  • ONH-MBR correlated with E/e' (left ventricular diastolic dysfunction marker).
  • Enlarged foveal avascular zone and thinner central retinal thickness (CRT) and choroidal thickness (CCT) in HFpEF patients.

Conclusions:

  • Ocular circulatory and structural changes are detectable in HFpEF.
  • LSFG and OCT/OCTA can identify these changes, potentially linking ocular findings to cardiac function.
Abstract

Keywords:
Heart failureLaser speckle flowgraphyNon-invasive imagingOcular circulationOptical coherence tomography angiography

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