PurposeTo investigate the relationship between retinal perfusion and retinal thickness in the peripapillary and macular areas of healthy subjects.MethodsUsing spectral-domain optic coherence tomography and split-spectrum amplitude decorrelation angiography (SSADA) algorithm, retinal perfusion and retinal thicknesses in the macular and peripapillary areas were measured in healthy volunteers, and correlations among these variables were analyzed.ResultsOverall, 64 subjects (121 eyes) including 28 males and 36 females with a mean ± SD age of 38 ± 13 years participated. Linear mixed-models showed that vessel area density was significantly correlated with the inner retinal thickness (from the inner limiting membrane to the outer border of the inner nucleus layer; P < 0.05), but not with the thickness of the full retina (P > 0.05) in the parafoveal area. The area of the foveal capillary-free zone was negatively correlated with the inner and full foveal thicknesses (all P < 0.001). In the peripapillary area, the vessel area density was positively correlated with the thickness of the retinal nerve fiber layer (P < 0.001).ConclusionsIn healthy subjects, retinal perfusion in small vessels was closely correlated with the thickness of the inner retinal layers in both the macular and peripapillary areas.
The impairment of retinal vascular autoregulation can be an early manifestation of many systemic and ocular diseases. Therefore, quantifying retinal vascular autoregulation in a non-invasive manner is very important. This study evaluated the effects of a Valsalva maneuver (VM)-induced blood pressure increases on retinal vascular autoregulation. Parafoveal and peripapillary retinal vessel density were measured with optical coherence tomography angiography before (baseline) and 5 s after each subject completed a VM (Phase IV [VM-IV]). Hemodynamic parameters and intraocular pressure (IOP) were examined. Blood pressure (systolic, diastolic, and mean arterial) and ocular perfusion pressure significantly increased during VM-IV, but IOP and heart rate (HR) did not change. The VM-induced blood pressure overshoot significantly decreased parafoveal (8.43%) and peripapillary (1.57%) perfused retinal vessel density (both P < 0.001). The response in the parafoveal region was greater than that in the peripapillary region (P < 0.001), and was age-dependent (r = 0.201, P < 0.05). Foveal avascular zone area detectable with OCTA significantly increased from baseline by 6.63% during VM-IV (P < 0.05). Autoregulatory responses to a VM did not show gender-related differences in either retinal region. The autoregulation of retinal vessels may vary in different regions of the fundus. Optical coherence tomography angiography could be a useful method for evaluating the autoregulation of the retinal vascular system.
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