Retina Vascular Perfusion Dynamics During Exercise With and Without Face Masks in Healthy Young Adults: An OCT Angiography Study

Hua, Dihao; Xu, Youming; Heiduschka, Peter; Zhang, Wenliang; Zhang, Xiao; Zeng, Xiangbing; Zhu, Xiangxiang; He, Tao; Zheng, Hongmei; Xiao, Xuan; Xing, Yiqiao; Chen, Zhen; Chen, Changzheng

doi:10.1167/tvst.10.3.23

Cited by 17 publications

(13 citation statements)

References 32 publications

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“…Most included studies were randomized crossover studies ( n = 42), while two studies were randomized controlled trials [ 24 , 25 ] and one study used a non-randomized repeated measure [ 26 ]. Except for three studies that involved children [ 27 – 29 ], all the other studies involved adults, including athletes ( n = 3) [ 30 – 32 ], recreational athletes ( n = 2) [ 33 , 34 ], and healthy adults ( n = 37) [ 3 , 12 – 15 , 18 , 24 – 26 , 35 – 62 ], with a total of 1264 participants (708 men, 556 women) included. Overall, 37 studies included both men and women, while eight included only men.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 22 studies used a progressive exercise test [ 3 , 12 , 14 , 18 , 24 , 26 , 30 , 35 , 36 , 39 , 41 , 43 – 45 , 48 , 50 , 51 , 53 – 55 , 59 , 60 ], while 19 employed the steady-state constant exercise test [ 13 , 15 , 25 , 29 , 31 , 34 , 37 , 38 , 40 , 42 , 46 , 47 , 49 , 52 , 56 – 58 , 61 , 62 ], and two used interval exercise tests [ 28 , 32 ]. Moreover, one study used a resistance exercise test [ 33 ], and one used a sit-to-stand test [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

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Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis

et al. 2022

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Background Wearing face masks in public is an effective strategy for preventing the spread of viruses; however, it may negatively affect exercise responses. Therefore, this review aimed to explore the effects of wearing different types of face masks during exercise on various physiological and psychological outcomes in healthy individuals. Methods A literature search was conducted using relevant electronic databases, including Medline, PubMed, Embase, SPORTDiscus, Web of Science, and Cochrane Central Register of Controlled Trials on April 05, 2022. Studies examining the effect of mask wearing (surgical mask, cloth mask, and FFP2/N95 respirator) during exercise on various physiological and psychological parameters in apparently healthy individuals were included. For meta-analysis, a random effects model was used. Mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CI) were calculated to analyze the total effect and the effect in subgroups classified based on face mask and exercise types. The quality of included studies was examined using the revised Cochrane risk-of-bias tool. Results Forty-five studies with 1264 participants (708 men) were included in the systematic review. Face masks had significant effects on gas exchange when worn during exercise; this included differences in oxygen uptake (SMD − 0.66, 95% CI − 0.87 to − 0.45), end-tidal partial pressure of oxygen (MD − 3.79 mmHg, 95% CI − 5.46 to − 2.12), carbon dioxide production (SMD − 0.77, 95% CI − 1.15 to − 0.39), and end-tidal partial pressure of carbon dioxide (MD 2.93 mmHg, 95% CI 2.01–3.86). While oxygen saturation (MD − 0.48%, 95% CI − 0.71 to − 0.26) decreased slightly, heart rate was not affected. Mask wearing led to higher degrees of rating of perceived exertion, dyspnea, fatigue, and thermal sensation. Moreover, a small effect on exercise performance was observed in individuals wearing FFP2/N95 respirators (SMD − 0.42, 95% CI − 0.76 to − 0.08) and total effect (SMD − 0.23, 95% CI − 0.41 to − 0.04). Conclusion Wearing face masks during exercise modestly affected both physiological and psychological parameters, including gas exchange, pulmonary function, and subjective discomfort in healthy individuals, although the overall effect on exercise performance appeared to be small. This review provides updated information on optimizing exercise recommendations for the public during the COVID-19 pandemic. Systematic Review Registration Number This study was registered in the International Prospective Register of Systematic Review (PROSPERO) database (registration number: CRD42021287278). Supplementary Information The online version contains supplementary material available at 10.1007/s40279-022-01746-4.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis

et al. 2022

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“…Abbreviations: CI, confidence interval; SD, standard deviation; SpO 2 , oxygen saturation level; Std. mean diff., standard mean difference [ 4 , 5 , 10 , 11 , 12 , 13 ].…”

Section: Figurementioning

confidence: 99%

Effect of N95 Respirator on Oxygen and Carbon Dioxide Physiologic Response: A Systematic Review and Meta-Analysis

Wangsan

Sapbamrer

Sirikul

et al. 2022

IJERPH

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During the COVID-19 pandemic, N95 respirators were commonly used in many situations. Respiratory problems from prolonged use of respirators were discussed in many studies, which show varied results. From the inconclusive results, the current systematic review and meta-analysis discerned the effects of the N95 respirator by assessing the oxygen and carbon dioxide changes in both high- and low-to-moderate-intensity physical activities in a healthy population. Thirteen studies were identified for inclusion in the study. In high-intensity physical activities, our meta-analysis showed borderline lower oxygen saturation and higher carbon dioxide partial pressure, but oxygen saturation did not change in low-to-moderate physical activity. The use of N95 respirators could statistically affect the physiologic changes of carbon dioxide and oxygen in high-intensity physical activity among healthy participants, but this may not be clinically significant. Some users who have certain health conditions, such as respiratory problems, should be informed of the clinical symptoms related to hypercarbia and hypoxia for the early detection of adverse effects of N95 respirators.

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“…A study conducted by Hua D et al showed that these changes, associated with CO2 retention, reduced the retinal vessel density (VD) in the superficial plexus even under quiescent conditions, which might have clinical implications for protecting healthy and indoor manual labor workers from potential risksdue to prolonged face mask use. 8 Their impacts on the retinal vessels are envisioned by the high resolution of spectral-domain optical coherence tomography (HR-SDOCT), which permits also the measurement of retinal vessel diameters and choroidal thickness. 9 In the present study, we aimed at investigating whether prolonged N95 respirators or surgical masks wearing induce retinal vessel diameters and choroidal changes visualized with HR-SDOCT.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the impact of N95 respirators or surgical masks use on the retinal microvasculature

Gündoğan

Akkaya

Bayram

2022

European Journal of Ophthalmology

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Purpose To determine the possible impact of wearing N95 respirator or surgical masks on retinal vessel diameters and choroidal thickness in healthy healthcare workers. Methods Diameters of peripapillary retinal arteries and veins and choroidal thickness values at the foveal center and at 1000 μm distances from the foveal center in both nasal and temporal directions were measured before mask wearing using a spectral-domain optical coherence tomography. After four hours (h) of N95 or surgical mask wearing vessel diameter and choroidal thickness measurements were repeated. Results A total of 52 eyes from 52 participants (28 F [53.8%]; 24 M [46.2%]) were enrolled in this study. The mean age of patients was 34.58 ± 5.24 years (25–44 years). The diameters of all measured arteries [inferior temporal artery (p = 0.003), superior temporal artery (p < 0.001), inferior nasal artery (p = 0.003), and superior nasal artery (p = 0.004)] and veins,with the exception of superior nasal vein, (inferior temporal vein (p = 0.031), superior temporal vein (p = 0.027), inferior nasal vein (p < 0.001), and superior nasal vein (p = 0.063)] increased significantly after four hour use of N95 respirators and surgical maskswhen compared to baseline. There was also a significant diameter increase of the superior temporal (p < 0.001), inferior nasal veins (p < 0.001), and superior temporal artery (p = 0.037) for N95 respirators and surgical masks use, respectively. The differences in central subfoveal, temporal, and nasal choroidal thickness between baseline and after 4 h use of N95 respirators were statistically significant (From 366.73 ± 70.81 μm to 381.23 ± 69.29μm,p < 0.001 for the subfoveal; from 324.00 ± 64.13μm to 335.40 ± 61.35 μm, p = 0.007 for the temporal; from 297.40 ± 68.18 μm to 308.23 ± 74.51μm, p = 0.002 for the nasal thicknesses). Choroidal thickness values were also increased with surgical mask use. But only the increase in central subfoveal thickness was statistically significant (From 366.78 ± 71.00 μm to 372.58 ± 76.56 μm, p = 0.031 for the central subfoveal; from 297.42 ± 68.35 μmto 302.79 ± 73.05 μm, p = 0.068 for the nasal; from 324.01 ± 64.21μm to 330.33 ± 65.84, p = 0.117 for the temporal thicknesses). Conclusion With four hours use of N95 respirators or surgical face masks, retinal vessel diameters and choroidal thicknesses showed an increase in comparison to baseline measurements. Hemodynamic changes seen secondary to hypercapnia due to prolonged use of N95 respirators or surgical masks may also be observed in the retinal and choroidal circulation. Furthermore, the use of face masks should be taken into account while assessing the retinal microvasculature.

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Retina Vascular Perfusion Dynamics During Exercise With and Without Face Masks in Healthy Young Adults: An OCT Angiography Study

Cited by 17 publications

References 32 publications

Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis

Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis

Effect of N95 Respirator on Oxygen and Carbon Dioxide Physiologic Response: A Systematic Review and Meta-Analysis

Assessment of the impact of N95 respirators or surgical masks use on the retinal microvasculature

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