Abstract
Objectives: To evaluate the effect of heart failure with reduced ejection fraction (HFrEF) on retinal nerve fiber layer (RNFL) thickness.
 Methodology: The study included patients who were being followed at Kartal Kosuyolu High Speciality Training and Research Hospital for HFrEF and were referred to the Eye Clinic of the Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey between 2017-2019. Study participants were divided into two groups, one comprising HFrEF patients and a control group of patients without HF. Each patient underwent a routine ophthalmologic examination including best corrected visual acuity evaluation, intraocular pressure measurement, slit-lamp biomicroscopy and fundus examination. The RNFL of each patient was measured using spectral domain OCT.
 Results: A total of eyes of 37 HFrEF patients and 38 controls were evaluated. Superior RNFL thickness was 113.71±17.08 μm in the HFrEF group and 126.22 ± 13.68 μm in the control group (p=0.001). Inferior RNFL thickness was 117.88 ± 14.5 μm in the HFrEF group and 131.69 ± 12.93 μm in the control group (p<0.001). Average RNFL thickness in the HFrEF and control groups was 92.32 ± 10.22 μm and 103.31 ± 8.14 μm, respectively. There were significant differences between the study groups in all five parameters.
 Conclusion: In this study, RNLF thinning occurs in HFrEF compared to the control group that may be useful for demonstrate tissue perfusion deficiency in HFrEF.
Highlights
Heart failure (HF) may arise due to structural or functional cardiac defects leading to inadequate cardiac filling or pump function
Superior retinal nerve fiber layer (RNFL) thickness was 113.71±17.08 μm in the HF with reduced ejection fraction (EF) (HFrEF) group and 126.22 ± 13.68 μm in the control group (p=0.001)
In this study, RNLF thinning occurs in HFrEF compared to the control group that may be useful for demonstrate tissue perfusion deficiency in HFrEF
Summary
Heart failure (HF) may arise due to structural or functional cardiac defects leading to inadequate cardiac filling or pump function. HF is a complex clinical syndrome characterized by tiredness, shortness of breath with exertion, orthopnea, paroxysmal nocturnal dyspnea, nocturia, alterations of mental state, anorexia and abdominal pain. EF is calculated by dividing the stroke volume (i.e. end-diastolic volume minus end-systolic volume) by the end-diastolic volume. Key clinical studies conducted with patients with systolic heart failure (HF), or HF with reduced EF (HFrEF), have generally included patients with EF ≤35%. CHF with ocular perfusion deficiency can be described as structural or functional cardiac dysfunction resulting in the heart’s inability to supply sufficient oxygen to meet the metabolic needs of the tissues, despite normal filling pressures (or with elevated filling pressures).[1]
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