Evidence map›Paper›PMID 40971065›Full record

ReviewOphthalmology and therapy2025

Retinal and Choroidal Alterations in Heart Failure: A Systematic Review and Meta-analysis of OCT and OCT-A Findings with Emphasis on HFrEF.

Kia Bayat, Parisa Pooyan, Jay Chhablani, Mozhgan Rezaei Kanavi, Hamid Ahmadieh

Abstract readReview
In one paragraph

Review in Ophthalmology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kia BayatOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran. kiabayat1998@gmail.com.ORCID http://orcid.org/0000-0002-4368-9392
Parisa PooyanSchool of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Jay ChhablaniUPMC Eye Center (J.C.), University of Pittsburgh, Pittsburgh, PA, USA.
Mozhgan Rezaei KanaviOcular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hamid AhmadiehOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRetina and choroid, given their high metabolic demands, are vulnerable to ischemic injury during the hemodynamic instability associated with heart failure (HF). Despite this, posterior segment ocular changes in HF remain understudied. This systematic review and meta-analysis consolidates optical coherence tomography (OCT) and OCT angiography (OCT-A) findings in HF.

methodsWe conducted a comprehensive search of Web of Science, PubMed/MEDLINE, and EMBASE on March 15, 2025. A random-effects meta-analysis of six studies was performed using Hedges' g to estimate effect sizes, with six additional studies included for qualitative synthesis (total n = 1139 eyes). The meta-analysis was limited to studies on heart failure with reduced ejection fraction (HFrEF), as this was the only heart failure subtype with sufficient data for quantitative analysis.

resultsKey findings revealed significant reductions in parafoveal superficial capillary plexus vessel density (SCP VD) (Hedges' g = - 0.42, 95% CI - 0.78 to - 0.05, p = 0.03) and subfoveal choroidal thickness (Hedges' g = - 0.75, 95% CI - 1.31 to - 0.18, p = 0.01) in patients with HFrEF. Furthermore, severity-dependent thinning of retinal nerve fiber layer and significant correlations between whole macular vessel density and both left ventricular EF and New York Heart Association functional class emphasize the potential of these parameters in stratifying disease severity. Additionally, one study revealed thinning of ganglion cell-inner plexiform layer in patients with HF with preserved ejection fraction (HFpEF). Those with acute decompensated HF showed macular VD attenuation in superficial layers and decreased subfoveal choroidal thickness. Pediatric cases demonstrated central macular thinning, selective decreases in SCP VD, and choroidal thinning.

conclusionsCollectively, OCT and OCT-A metrics provide useful information regarding systemic microvascular dysfunction, suggesting potential for disease detection and improved risk stratification. However, it is important to note that these findings are based on observational studies, which limits the ability to draw definitive causal conclusions. This highlights the need for prospective, longitudinal research to establish temporal relationships and validate these observations.

Indexed as

ChoroidDiastolic heart failureOptical coherence tomographyOptical coherence tomography angiographyRetinaSystolic heart failure

Identifiers

PMID40971065
PMCPMC12534680

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.