Abstract
Purpose: To examine the relationship between the cardiovascular status and variations in optical coherence tomography (OCT)-derived parameters of the peripapillary and macular tissues, and macular vascular flow area measured by optical coherence tomography angiography (OCTA) in healthy subjects.
 Design: Prospective, open-label, non-randomized clinical study.
 Methods: Twenty one eyes of 21 healthy subjects were analyzed using a swept-source device, including OCT and OCTA acquisitions. Cardiovascular changes were investigated by performing a practical hand-grip test (HGT). Blood pressure, heart rate, OCT and OCTA structural and vascular changes were measured and analyzed before and after the HGT-induced exercise.
 Results: The mean patient age was 34.0 (± 15.2) years. While both diastolic and systolic blood pressures increased significantly aft er exercise (p < 0.001 and p = 0.003, respectively), the heart rate did not show a significant increment (p = 0.182). OCT structural parameters of the optic nerve did not change significantly. Instead, a significant redistribution of choroidal thickness (CT) was observed in the macular region, with a significant reduction (-6.5%, p = 0.001) in the outer-nasal macular sector after exercise. OCTA acquisitions did not show changes in the vascular density of both the superficial retinal layer and deep retinal layer.
 Conclusions: We demonstrated that HGT-induced exercise can moderately elevate blood pressure without detectable effects on OCTA-derived parameters in healthy young subjects. Moreover, it produced a significant redistribution of CT. Further studies are needed to better explain the possible role of HGT in the characterization of the pathophysiology of ocular diseases associated with abnormalities of the vascular function such as glaucoma, age-related macular degeneration, and diabetic retinopathy.
Highlights
The retina represents one of the most metabolically active tissues in the body, since it receives a double blood supply deriving from both the retinal and choroidal circulations.[1]
We demonstrated that hand-grip test (HGT)-induced exercise can moderately elevate blood pressure without detectable effects on optical coherence tomography angiography (OCTA)-derived parameters in healthy young subjects
Several studies analyzed the different factors influencing choroidal blood flow measured by Laser Doppler flowmetry (LDF) during isometric exercise, showing the complex regulatory mechanisms associated with variations in mean arterial pressure (MAP), intraocular pressure (IOP), and ocular perfusion pressure (OPP).[6,7]
Summary
The retina represents one of the most metabolically active tissues in the body, since it receives a double blood supply deriving from both the retinal and choroidal circulations.[1]. Optical coherence tomography (OCT) represents a widely used non-invasive imaging technique to assess changes in the structure of the different anatomical regions of the retina caused by pathologic processes. Several imaging methods are available to assess the retinal and choroidal blood flow; to date, none has been recognized as gold s tandard.[2,3,4] Laser Doppler flowmetry (LDF) is a non-invasive technique that measures the Doppler shift caused by the movement of erythrocytes.[5] Several studies analyzed the different factors influencing choroidal blood flow measured by LDF during isometric exercise, showing the complex regulatory mechanisms associated with variations in mean arterial pressure (MAP), intraocular pressure (IOP), and ocular perfusion pressure (OPP).[6,7] laser speckle flowgraphy is another novel non-invasive technique based on the interference phenomenon, and it has shown reproducible data and a good reliability profile with LDF in the study of choroidal blood flow.[8] Doppler optical coherence tomography (Doppler-OCT) is another diagnostic tool studied for the retinal and choroidal analysis; further in vivo studies are needed in order to better clarify its clinical reliability.[9]
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