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. 2022 Mar;42(2):367-375.
doi: 10.1111/opo.12935. Epub 2021 Dec 16.

Choroidal vascularity index changes during the Valsalva manoeuvre in healthy volunteers

Mehmet Orkun Sevik  1 , Furkan Çam  1 , Aslan Aykut  1 , Volkan Dericioğlu  1 , Özlem Şahin  1
Affiliations

Choroidal vascularity index changes during the Valsalva manoeuvre in healthy volunteers

Mehmet Orkun Sevik et al. Ophthalmic Physiol Opt. 2022 Mar.

Abstract

Purpose: To evaluate the effects of the Valsalva manoeuvre (VM) on the choroidal vascularity index (CVI) in healthy volunteers.

Methods: This prospective, cross-sectional study included 60 eyes of 30 healthy volunteers. Enhanced depth imaging-optical coherence tomography scans of both eyes involving the fovea were taken, and a 1500 μm subfoveal choroidal area was selected for image binarization with open-access Fiji software. The binarized image was segmented into the stromal area (SA) and luminal area (LA), and CVI was calculated as the ratio (%) of LA to the total choroidal area (TCA). CVI, subfoveal choroidal thickness (SFCT), IOP, systolic and diastolic blood pressure were evaluated at rest and during the VM.

Results: During the VM, a mean ± standard deviation increase in LA (0.02 ± 0.05 mm2 , p < 0.001) and CVI (1.72 ± 2.83%, p < 0.001) was observed, whereas SA (-0.02 ± 0.05 mm2 , p < 0.001) decreased. There was no significant change in TCA (0.00 ± 0.03 mm2 , p = 0.55) or SFCT (1.05 ± 10.92 μm, p = 0.46). There was a moderate positive correlation between the spherical equivalent refractive error (SE) and SFCT both at rest and during VM (r58 = 0.49, p < 0.0005 and r58 = 0.49, p < 0.0005, respectively). However, there was no significant correlation between SE and CVI either at rest or during VM (p = 0.11 and 0.06, respectively). In a multiple linear regression analysis, CVI was only associated with SFCT; however, SFCT was also associated with SE, both at rest and during VM (p < 0.001).

Conclusion: Valsalva manoeuvre increases CVI by choroidal vascular dilation as demonstrated by an increase in LA and a decrease in SA. Researchers should be careful about unintentional VM during examinations.

Keywords: Valsalva manoeuvre; choroidal vascularity index; enhanced depth imaging optical coherence tomography; subfoveal choroidal thickness.

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References

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