Linking cardiological parameters and choroidal changes in patients with precapillary pulmonary hypertension: a cross-sectional study

Diagnosing precapillary pulmonary hypertension (PPH) is challenging, and prognosis remains poor. This study aims to explore the pathogenesis of choroidal changes in these patients and assess whether choroidal parameters could serve as noninvasive biomarkers reflecting cardiovascular status. This prospective, single-center study included 29 adult PPH patients and 37 healthy controls. One eye per patient was analyzed. All participants underwent a full ophthalmological examination, including spectral domain-optical coherence tomography, and a cardiological evaluation comprising medical history, physical examination, echocardiography, right heart catheterization, laboratory, and functional tests. Univariable regression analyses assessed associations between choroidal parameters and clinical, demographic, and ocular features. PPH patients showed significantly reduced choroidal thickness and volume in the ETDRS subfields compared to controls (p < 0.01 for all). However, luminal, stromal, and total choroidal areas, as well as the choroidal vascularity index, did not differ significantly between groups. No significant relationships were found between cardiological and choroidal parameters. The choroid is affected in PPH patients, but choroidal parameters do not appear to be reliable biomarkers for PPH evaluation. Further studies are needed to clarify the potential role of choroidal vascularity index in PPH.