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Effects of hemoglobin concentration on retinochoroidal vascular plexuses: an optical coherence tomography angiography study

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Abstract

Purpose

To evaluate retinal and choroidal microvascular structures using optical coherence tomography angiography (OCTA) in patients with anemia and polycythemia vera (PV).

Methods

In this prospective study, 142 patients (142 eyes) were enrolled and divided into 3 groups: the anemia (n = 56), PV (n = 46), and healthy groups (n = 40, controls). For each patient, 6- × 6-mm macular angiography images were taken using an OCTA system (optovue, Inc., Fremont). For each eye analyzed, the software automatically measured vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP; superior, nasal, temporal, and inferior quadrants), choriocapillaris (CC), and foveal avascular zone (FAZ).

Results

The OCTA analysis revealed that the VD of the DCP was significantly decreased in the superior and inferior hemispheres of the whole area, multiple quadrants of the perifovea, and CC with a 1-mm2 flow area in the anemia group compared with the PV group (p < 0.017), but the VD of the SCP did not show any significant difference in any quadrant between the two groups (p > 0.017). When compared with the healthy group, the anemia and PV groups showed a significant difference in multiple quadrants of the parafovea and temporal quadrant of the perifovea in the VD of the SCP and CC with a 2-mm2 flow area (p < 0.017). The FAZ and non-flow area did not manifest any significant difference between the groups (p > 0.017). The hemoglobin concentrations in the anemia, PV, and healthy groups were 8.11 ± 1.33, 17.5 ± 1.2, and 15.6 ± 0.73 g/dL, respectively, indicating statistically significant differences between the groups (p < 0.001).

Conclusion

In this study, quantitative OCTA analysis revealed a higher tendency for retinal and choroidal microvascular morphological changes in patients with anemia and PV. The outcomes of the current investigation can provide new insights into the retinal and choroidal pathophysiologies found in patients with hemoglobin abnormalities.

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Availability of data and materials

The datasets used or analyzed during the current study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Etlik City Hospital, Halil Sezai Erkut Caddesi No:5, Yenimahalle, Ankara, Turkey

    Selda Celik Dulger, Seda Cevik Kaya & Mehmet Yasin Teke

  2. AnkaraTraining and Research Hospital, Ankara, Turkey

    Turgay Fen

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  1. Selda Celik Dulger
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  2. Seda Cevik Kaya
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  3. Turgay Fen
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  4. Mehmet Yasin Teke
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SCD wrote the main manuscript SK, TF, and MYT reviewed the manuscript

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Correspondence to Selda Celik Dulger.

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This study was approved by the Ethical Committee of Ankara Etlik City Hospital.

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Celik Dulger, S., Cevik Kaya, S., Fen, T. et al. Effects of hemoglobin concentration on retinochoroidal vascular plexuses: an optical coherence tomography angiography study. Int Ophthalmol 44, 117 (2024). https://doi.org/10.1007/s10792-024-03029-5

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