Retinal Nerve Fiber Layer in Aortic Coarctation Patients
DOI:
https://doi.org/10.48560/rspo.33098Keywords:
Aortic Coarctation, Biomarkers, Nerve Fibers, Retinal Diseases, Retinal VesselsAbstract
INTRODUCTION: Aortic coarctation (COA) is a congenital cardiovascular defect characterized by a narrowed aorta, leading to increased afterload and significant hypertension. COA is associated with severe vascular complications, including coronary atherosclerosis, cerebrovascular accidents, and sudden death. Given the link between retinal microvascular changes and cerebrovascular disease and considering the shared embryological development between the brain and heart in congenital cardiac disease, we can observe vascular lesions caused by COA through transneural degeneration. Detecting and monitoring related-vascular damage in COA patients is crucial to prevent these complications. Notably, the retinal nerve fiber layer (RNFL) shows promising potential as a non-invasive biomarker, providing insights into COA patients’ vascular health. Our purpose was to evaluate alterations in RNFL thickness in COA patients using spectral- domain optical coherence tomography (SD-OCT).METHODS: Prospective data were collected from patients diagnosed with COA and healthy controls. SD-OCT was performed to measure peripapillary RNFL in both eyes of each patient.
RESULTS: Forty-eight patients with COA diagnosis (COA group; mean [SD] age, 21.0 [8.4] years; 32 males [67%]) and 48 healthy normal controls (control group; mean [SD] age, 21.4 [8.8] years; 23 males [49%]) were included in this study. In univariate analysis, peripapillary RNFL thickness was reduced in both eyes in the COA group compared with the control group in the global parameter (OD, p = 0.058; OS, p = 0.036), superior-nasal (OD, p = 0.006; OS, p = 0.006), and superior-temporal (OD, p = 0.023; OS, p = 0.085). In multivariate logistic regression analysis, only the supero-nasal sector in both eyes showed a significant reduction in peripapillary RNFL thickness on COA group (right eye: coef = 12.83 Std err = 4.44, p-value = 0.005, 95% CI = [4.00 – 21.66]; left eye: coef = 12.80, Std err = 4.16, p-value = 0.003, 95% CI = [4.54 – 21.07]) after adjusting for age, male sex, blood pressure, and IOP.
CONCLUSION: These findings suggest that COA patients might exhibit significant alterations in RNFL thickness, particularly in specific sectors, indicating potential neurological repercussions. Such insights could have valuable implications for the early detection and management of COA-related vascular complications, potentially serving as a non-invasive biomarker.
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