IMPACT OF ATRIAL FIBRILLATION ON BLOOD FLOW IN THE POSTERIOR SEGMENT OF THE EYE

Background: Retinal microvascular perfusion (RMVP) is analyzed by angio-OCT. There is little data on the impact of atrial fibrillation (AF) on the changes in RMVP. Aims: The aim of the study is to analyze the impact of atrial fibrillation (AF) on blood flow (blood perfusion) in the posterior segment of the eye in patients treated with direct oral anticoagulants (DOACs), using a new technology based on optical coherence tomography angiography (OCTA). The study focuses on the blood perfusion relationship in patients treated with DOACs. This case-control Method: study included 20 patients diagnosed with permanent atrial fibrillation (AF) and heart failure (HF), which were compared with 20 healthy volunteers. To assess blood perfusion, a series of central retinal measurements were performed in each patient, assessing blood perfusion parameters using the Zeiss AngioPlex OCT Cirrus 5000 angiography platform with the FastTrac™ function. Results: In patients with AF and HF, the vessel density in both eyes was significantly lower than in healthy people (without AF). In healthy controls, vessel density was significantly higher than in patients treated with dabigatran. Interestingly, vascular density was similar in patients treated with rivaroxaban compared to healthy controls. Conclusions: Patients with stable HF and permanent AF had lower vessel density in the superficial retinal vascular plexus compared to the healthy control group. Furthermore, rivaroxaban had a beneficial effect on the vessels of the superficial retinal vascular plexus, reducing vascular damage in patients with AF. The detailed mechanism of this positive effect requires further investigation in larger clinical cohorts.