Retinal microvasculature impairment in patients with congenital heart disease investigated by optical coherence tomography angiography

作者：Li, Cong; Zhong, Pingting; Yuan, Haiyun; Dong, Xinran; Peng, Qingsheng; Huang, Manqing; Wu, Qiaowei; Liu, Baoyi; Xu, Minghui; Kuang, Yu; Zeng, Xiaomin; Xiao, Yu; Fang, Ying; Yu, Honghua^*; Yang, Xiaohong^*

来源：Clinical and Experimental Ophthalmology, 2020, 48(9): 1219-1228.

DOI：10.1111/ceo.13846

• congenital heart disease
• hypoxia
• retinal vessel density
• optical coherence tomography angiography

Importance A high prevalence of retinal abnormalities have been reported in congenital heart disease (CHD), but quantitative analysis of retinal vasculature is scarce. Optical coherence tomography angiography (OCTA) is a noninvasive method to quantitatively assess the retinal microvasculature. Background To investigate the retinal microvasculature changes in CHD patients by using OCTA. Design Cross-sectional study. Participants A total of 158 participants including 57 cyanotic CHD (CCHD) patients, 60 acyanotic CHD (ACHD) patients and 41 control subjects were included. Methods All participants underwent a comprehensive ophthalmologic examination, including refraction measurement, intraocular pressure measurement and OCTA. Main Outcome Measures Vessel density (VD) was measured within the radial peripapillary capillary (RPC), superficial capillary plexus (SCP) and deep capillary plexus (DCP) of the macula. Results CCHD patients had significantly lower VD in the RPC, SCP and DCP (allP < .01) compared to control subjects, and significantly lower VD in the RPC and DCP (bothP < .05) compared to ACHD patients. Besides, among the CHD group, VD in the RPC was positively correlated with oxygen saturation (whole image,rho= 0.45; peripapillary,rho= 0.48) and negatively correlated with haematocrit (whole image,rho= 0.55; peripapillary,rho= 0.55) (allP < .001). Conclusions and Relevance Retinal VD might be a surrogate to reflect the effect of chronic systemic hypoxemia in CHD patients. OCTA could be a convenient and noninvasive tool to evaluate the retinal structure and function in CHD patients.

• 单位
  汕头大学; 广东省心血管病研究所; 南方医科大学; 广东省人民医院