Acute retinochoroidal and photoreceptor responses after short-term mobile E-sports gaming: a multimodal SS-OCTA and AO-SLO study

To observe the hemodynamic and morphological changes in the macular retinochoroidal microcirculation and cone photoreceptor following short-term mobile e-sports. This observational study enrolled 35 healthy young participants. After a standardized 15-minute resting period, participants played a 15-minute mobile game ( Honor of Kings ). Before and after the game, swept-source optical coherence tomography (SS-OCT) was used to measure subfoveal choroidal thickness (SFCT), and swept-source optical coherence tomography angiography (SS-OCTA) was used to measure foveal choroidal vascular volume (CVV). Adaptive optics scanning laser ophthalmoscopy (AO-SLO) was utilized to track morphological parameter changes in cone photoreceptors. Following the high-intensity visual task, the participants’ posterior segments exhibited a considerable shift. Specifically, the CVV in the foveal region increased significantly from 0.163 (0.100, 0.215) mm 3 to 0.165 (0.100, 0.219) mm 3 ( P = 0.019 ). This was accompanied by significant regional choroidal thickening, with the 0–1 mm SFCT increasing from 361.83 (264.33, 465.79) µm to 363.61 (265.45, 476.47) µm ( P = 0.018 ). At the cellular level, AO-SLO analysis revealed that the temporal cone structure underwent spatial reorganization toward a more regular hexagonal array, with the proportion of hexagonal cells increasing significantly from 49.63% to 50.26% ( P = 0.026 ). Short-term mobile e-sports are associated with microvascular modulations and cone morphological alterations in the posterior segment following high-intensity visual workload. By overcoming the limitations of subjective assessments, this study highlights the potential of utilizing these dynamic retinochoroidal and photoreceptor changes as biomarkers to assess visual workload induced by the game.