Patients with chronic thromboembolic pulmonary hypertension (CTEPH) have different retinal and choroidal microvascular findings compared with healthy controls, including a decreased mean vessel density at the deep vascular complex of the macula and a decreased mean subfoveal choroidal thickness, Dr Przemysław Krajewski, PhD, reported.

Dr Krawkewski, who is from the Ophthalmology Department, Infant Jesus Teaching Hospital, Medical University of Warsaw, Warsaw, Poland, and colleagues conducted an observational clinical cohort study¹ to investigate the microvascular retinal and choroidal changes associated with CTEPH in patients compared with healthy control subjects.

The study included 36 patients (72 eyes) with CTEPH and 65 healthy control subjects (130 eyes). Optical coherence tomography (OCT) and OCT angiography images were obtained from each participant using the AngioVue Imaging System (Optovue, Inc., Freemont, California, USA).

Retinal findings

The research team reported a few differences in the patients with CTEPH that included a decreased mean vessel density at the deep vascular complex of the macula, a decreased mean subfoveal choroidal thickness, and an increase in the size of the foveal avascular zone.

In patients with CTEPH who had at least one systemic disease such as arterial hypertension, diabetes, chronic coronary syndrome, and/or hyperlipidemia, the range of the vascular complications increased. When a comorbidity was present there was an accompanying decrease in the mean vessel density in the superficial vascular complex of the macula, excluding the fovea, and a decrease in the mean vessel density in the radial peripapillary capillary plexus, the investigators reported.

The investigators theorized that measuring the foveal avascular zone and the vessel density of the deep vascular complex and subfoveal choroidal thickness may be useful and sensitive predictors of impaired retinal and choroidal circulation in patients with CTEPH without a systemic disease.

Reference

1. Krawjewski P, Turczyńska M, Gołębiewska J, et al. Optical coherence tomography angiography findings in patients with chronic thromboembolic pulmonary hypertension. Retina. 2022;42:2354-360; doi: 10.1097/IAE.0000000000003607