The alterations of retinal vasculature detected on optical coherence tomography angiography associated with chronic obstructive pulmonary disease

OBJECTIVES: This study aimed to evaluate the retinal vasculature of the macula and optic disc in patients with chronic obstructive pulmonary disease (COPD) by optical coherence tomography angiography (OCTA). METHODS: The right eyes of 70 COPD patients and 71 healthy individuals were evaluated. These patients had moderate airflow limitation and mean PO(2) of 60 mmHg, and their average age was less than 60 years. Superficial and deep capillary plexus vascular densities, foveal avascular zone (FAZ) width, and optic disc parameters were measured with OCTA. In addition, the correlation between the PO(2) level in COPD patients and superficial, deep, and peripapillary vascular densities and FAZ was examined in the study. RESULTS: The COPD group had a significant decrease in the vascular density in the superficial (fovea [p = 0.019]; parafovea [p = 0.013]; and perifovea [p = 0.001]) and deep capillary plexus (fovea [p = 0.028]; parafovea [p = 0.005]; and perifovea [p = 0.002]). Also, the enlargement of the FAZ (p = 0.002) and a decrease in the peripapillary vascular density (p = 0.006) were observed in the COPD group. There was a positive correlation between PO(2) level and superficial, deep, and peripapillary vascular densities in COPD patients and a negative correlation with FAZ (r = 0.559–0.900). CONCLUSION: Hypercapnia, respiratory acidosis, and chronic hypoxia associated with COPD may affect the macula and optic nerve, resulting in a serious decrease in vascular density, and OCTA can be a very important tool in the follow‐up and treatment of these patients.