The assessment of acute chorioretinal changes due to intensive physical exercise in young adults

Abstract

Purpose There is abundant evidence on the benefits of physical activity on cardiovascular health. However, there are only few data on the acute effects of physical exercise on the retina and choroid. Our aim was the in vivo examination of chorioretinal alterations following short intense physical activity by spectral domain optical coherence tomography (SD-OCT). Methods Twenty-one eyes of 21 healthy, young subjects (mean age 22.5 ± 4.1 years, 15 males and 6 females) were recruited. Macular scanning with a SD-OCT was performed before and following a vita maxima-type physical strain exercise on a rowing ergometer until complete fatigue. Follow-up OCT scans were performed 1, 5, 15, 30 and 60 minutes following the exercise. The OCT images were exported and analyzed using our custom-built OCTRIMA 3D software and the thickness of 7 retinal layers was calculated, along with semi-automated measurement of the choroidal thickness. One-way ANOVA analysis was performed followed by Dunnett post hoc test for the thickness change compared to baseline and the correlation between performance and thickness change has also been calculated. The level of significance was set at 0.001. Results We observed a significant thinning of the total retina 1 minute post-exercise (-7.3 ± 0.6 μm, p < 0.001) which was followed by a significant thickening by 5 and 15 minutes (+3.6 ± 0.6 μm and +4.0 ± 0.6 μm, respectively, both p <0.001). Post-exercise retinal thickness returned to baseline by 30 minutes. This trend was present throughout the most layers of the retina, with significant changes in the ganglion cell–inner plexiform layer complex, (-1.3 ± 0.1 μm, +0.6 ± 0.1 μm and +0.7 ± 0.1 μm, respectively, p <0.001 for all), in the inner nuclear layer at 1 and 5 minutes (-0.8 ± 0.1 μm and +0.8 ± 0.1 μm, respectively, p <0.001 for both), in the outer nuclear layer–photoreceptor inner segment complex at 5 minute (+2.3 ± 0.4 μm, p <0.001 for all) and in the interdigitation zone–retinal pigment epithelium complex at 1 and 15 minutes (-3.3 ± 0.4 μm and +1.8 ± 0.4 μm, respectively, p <0.001 for both). There was no significant change in choroidal thickness; however, we could detect a tendency towards thinning at 1, 15, and 30 minutes following exercise. The observed changes in thickness change did not correlate with performance. Similar trends were observed in both professional and amateur sportsmen (n = 15 and n = 6, respectively). The absolute changes in choroidal thickness did not show any correlation with the thickness changes of the intraretinal layers. Conclusions Our study implies that in young adults, intense physical exercise has an acute effect on the granular layers of the retina, resulting in thinning followed by rebound thickening before normalization. We could not identify any clear correlation with either choroidal changes or performance that might explain our observations, and hence the exact mechanism warrants further clarification. We believe that a combination of vascular and mechanic changes is behind the observed trends.

The Assessment of Acute Chorioretinal Changes Due to Intensive Physical Exercise in Senior Elite Athletes

“…Although this trend was also present in the single nuclear layers of the retina, mostly in the outer retina, these changes did not reach statistical significance at the level of segmentation results. Nonetheless, these changes resemble the observations made in young adults undergoing vita maxima strain wherein the same acute significant thinning was described, followed by significant thickening of the total retina and the nuclear layers (Szalai et al, 2022). In the young adult population, it has been postulated that the reason behind the observations might be twofold.…”

“…Second, in case the acute changes in IOP might play a role in the acute thinning observed at 1 min (either per se or by complementing the vasogenic response), it might be postulated that acute exercise leads to less IOP increase in the senior cohort. However, the elevation of BP during exercise in the elite senior athletes was very similar to that in young athletes due to the controlled conditions in the senior cohort to avoid CV complications (Szalai et al, 2022).…”

IMI—The Dynamic Choroid: New Insights, Challenges, and Potential Significance for Human Myopia

“…Given that physical activity is known to alter blood flow in a variety of organs and tissues, choroidal effects would seem plausible. However, while early studies showed changes in choroidal blood flow with exercise as measured with laser Doppler flowmetry, 160 most studies examining ocular parameters shortly after physical exercise did not detect significant changes in choroidal thickness, 151 , 161 – 164 with the exception in some studies of a temporary choroidal thickening a few minutes after exercise, followed by a reduction in thickness. 4 , 150 On the other hand, thinning of the choroid was observed after endurance exercise (marathon running).…”

Impact of multifocal gas-permeable lens designs on short-term choroidal response, axial length, and retinal defocus profile

“…Additionally, the OCT follow-up feature was utilized to ensure that the OCT line image remained in the same position during baseline and follow-up visits. To order to reduce the influence from major known confounders to ChT and AL including physical activity [25] , near work [26] , and ambient light [27] . Subjects were instructed to spend 15min in a room with low photopic ambient light before the measurements, while focusing on a target placed at 3 m. The OCT scans were obtained with participants wearing MFGPCLs, given previous research indicating minimal impact of contact lens (CL) wear on OCT imaging of macular thickness [28] and retinal nerve fiber layer thickness [29] .…”