COPD & the eye: Ocular microstructures affected by chronic disease

In both patients and controls, investigators measured retinal nerve fiber layer thickness, foveal avascular zone area, and vessel density in the superficial capillary plexus, deep capillary plexus, and radial peripapillary capillary plexus.

Turkish physicians reported that ocular microstructures are affected by chronic obstructive pulmonary disease (COPD), with severe COPD having a greater effect,1 according to Tuğba Kurumoğlu İncekalan, MD, first study author, from the Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey.

İncekalan and colleagues conducted a prospective, cross-sectional study that included 66 patients with COPD and 54 age- and sex-matched healthy controls.

The patients with COPD subdivided into 3 groups based on disease severity: mild, moderate, and severe COPD, based on the spirometric parameters of the Global Initiative for Chronic Obstructive Lung Disease guidelines.2

The following ocular structures were measured in the patients and controls by optical coherence tomography: retinal nerve fiber layer (RNFL) thickness, foveal avascular zone area, and vessel density in the superficial capillary plexus, deep capillary plexus, and radial peripapillary capillary plexus. The measurements were compared between the 2 groups.

The investigators reported that there were no significant difference between the patients with COPD and controls in the foveal avascular zone area or RNFL thickness (P = 0.891 and P = 0.896, respectively).

They also found that the patients with severe COPD had lower vessel density in the superficial capillary plexus compared with the other groups but the difference did not reach significant (P > 0.05).

In the deep capillary plexus, the vessel density did not differ significantly among the groups in the foveal region (P > 0.05) but was significantly lower in all parafoveal quadrants in the patients with severe COPD. The radial peripapillary capillary plexus vessel density also was lower in the patients with severe COPD, especially in the peripapillary region (P = 0.044).

“Although COPD is primarily a lung disease, the eye seems to be among the tissues affected during the natural course of COPD. The effects are more pronounced in patients with severe COPD and in the deep capillary plexus and radial peripapillary capillary plexus,” they concluded.

Reference
1. Incekalan TK, Safçı SB, Şimdivar GHN. Investigation of ocular microstructural changes according to disease severity in patients with chronic obstructive pulmonary disease. Can J Ophthalmol 2022; Published October 25, 2022; DOI:https://doi.org/10.1016/j.jcjo.2022.10.001
2. Global strategy for diagnosis, management and prevention of COPD. Global Initiative for Chronic Obstructive Lung Diseases (GOLD) 2021 report [Internet]. Available at: https://goldcopd.org/2021-gold-reports/