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Choroidal thickness and the continuum of heart failure – The Gutenberg Health Study

Laufzeit: 01.01.2016 - 31.12.2017

Kurzfassung


Aims:
(1) To assess associations between choroidal thickness and heart failure

The choroidea is a vascular layer of the eye lying between the retina and the sclera. It consists of vessels ending in capillaries with a thin endothelium layer with high leakage for diffusion. The choroid supplies the retinal pigment epithelium and the outer part of the photoreceptors by diffusion. It consists of a three main layers: the Haller’s layer consisting of large choroidal vessels, the Sattler’s layer with...
Aims:
(1) To assess associations between choroidal thickness and heart failure

The choroidea is a vascular layer of the eye lying between the retina and the sclera. It consists of vessels ending in capillaries with a thin endothelium layer with high leakage for diffusion. The choroid supplies the retinal pigment epithelium and the outer part of the photoreceptors by diffusion. It consists of a three main layers: the Haller’s layer consisting of large choroidal vessels, the Sattler’s layer with choroidal vessels of medium size and the choriocapillaris. Enhanced depth imaging of spectra-domain optical coherence tomography (OCT) allows to visualize the overall choroidal thickness reaching from the retinal pigment epithelium/Bruch’s membrane to the sclera. Previous studies have reported associations of choroidal thickness to a variety of systemic and ophthalmic diseases.
The evaluation of the choroidal thickness as cardiovascular parameter is recently set into focus of scientific research. Several case-control studies showed an association between choroidal thickness measurements and cardiovascular parameters: there is evidence for choroidal exsudation in patients with severe arterial hypertension being visible in a thicker choroidea (Ahn et al.) After sufficient antihypertensive therapy, choroidal thickness decreased in these patients (Ahn et al.). There is also a link to heart functioning: a smaller ejection fraction of the left heart is associated with a thinner choroidea (Altinkaynak et al.).
With this study, we want to determine the association between choroidal thickness and the continuum of heart failure in a large population-based study. We expect that thinner choroidal thickness is associated with both symptomatic and asymptomatic heart failure. Our assumption is that choroidal thickness reflects the hydration status. Therefore, choroidal thickness is expected to be stronger associated with “diastolic” heart failure (heart failure with preserved ejection fraction: HFPEF, and asymptomatic isolated diastolic heart failure), than with systolic (with reduced ejection fraction: HFREF or asymptomatic isolated systolic heart failure). We expect in general that due to the extent of the disease, symptomatic HF is stronger associated than asymptomatic HF with the CT. We will further explore the relation with the clinical symptoms according to NYHA in all phenotypes of HF.
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