Impact des marathons contre la santé oculaire ?

[Nutrimuscle-Conseils]

Retinal and choroidal blood flow variations after an endurance exercise: A real-life pilot study at the Paris Marathon
Martine Mauget-Faÿsse Journal of Science and Medicine in Sport Volume 24, Issue 11, November 2021, Pages 1100-1104


Objectives
To collect information about the retinal blood flow variations and other choroidal and retinal parameters during a prolonged effort such as marathon running.

Design
Non-randomized prospective cohort study.

Methods
Patients were recruited through an information campaign at the Rothschild Foundation Hospital (Paris, France). A first visit (V1) was planned in the month before the marathon. All participants underwent blood pressure measurement, fundus photography, spectral domain-optical coherence tomography (SD-OCT) and OCT-angiography (OCT-A). A second visit (V2) was scheduled within one hour of crossing the finish line. The same tests were repeated, using the same equipment.

Results
Of the 31 runners who were included, 29 finished the marathon and attended V2. At baseline, various ophthalmological abnormalities were found in 45.2% of the 58 eyes, among which almost a third concerned the optic nerve and a quarter the pachychoroid spectrum. A significant decrease in retinal vascular plexus density was found between V1 and V2 (p < 0.01). While median macular and retinal nerve fiber layer (RNFL) thicknesses significantly increased after the marathon (p < 0.01), median choroidal thickness significantly decreased (p < 0.01). Both systolic and diastolic blood pressures significantly decreased (p < 0.01 and p = 0.021 respectively).

Conclusions
Prolonged physical effort impacts the structure and vascularization of the retina and the choroid. Hypoxia and dehydration due to such an effort may induce a low ocular blood flow rate resulting in a choroidal thinning, contrasting with a transient subclinical ischemic edema of the inner retina and optic nerve head.

[Nutrimuscle-Conseils]

Optical Coherence Tomography Angiography Quantitative Assessment of Exercise-Induced Variations in Retinal Vascular Plexa of Healthy Subjects
Sétha Vo Kim Invest Ophthalmol Vis Sci . 2019 Apr 1;60(5):1412-1419.

Purpose: To assess the variations induced by exercise in retinal vascular density (VD), foveal avascular zone (FAZ) area, and fractal dimension (FD) at the superficial (SCP) and deep (DCP) capillary plexa in healthy subjects by means of optical coherence tomography angiography (OCT-A).

Methods: Consecutive healthy subjects were prospectively included into two groups, ranging in age from 18 to 29 years for group 1 and from 30 to 40 years for group 2. Data from 3 × 3-mm OCT-A acquisition centered on the macula at SCP and DCP (VD, FAZ area, and FD), heart rate, and systolic-diastolic blood pressure were collected before and after a 20-minute standardized physical exercise on a stationary bicycle.

Results: Both eyes of 32 healthy volunteers were prospectively included (15 in group 1 and 17 in group 2). Mean age was 27 ± 7 years. In the overall analysis and for each group, a decrease of VD at the level of SCP and an increase of FD at the level of DCP were significant after exercise. A significant correlation was found between these modifications of retinal vascularization and the increase of systolic blood pressure induced by exercise. All cardiovascular parameters increased significantly with exercise. No significant difference was found between the two groups, and no incident was reported.

Conclusions: A significant correlation was established between systemic cardiovascular modifications (reflected by systolic blood pressure) and local retinal vascularization changes at SCP during exercise. A rest period might be recommended before OCT-A data acquisition, as modifications of cardiovascular parameters could distort retinal vascular data.

[Nutrimuscle-Diététique]

Traduction de l'étude

Tomographie par cohérence optique Angiographie Évaluation quantitative des variations induites par l'exercice dans le plexa vasculaire rétinien de sujets sains
Sétha Vo Kim Invest Ophtalmol Vis Sci . 1er avril 2019 ; 60 (5) : 1412-1419.

Objectif : Évaluer les variations induites par l'exercice dans la densité vasculaire rétinienne (VD), la zone de la zone avasculaire fovéale (FAZ) et la dimension fractale (FD) au niveau du plexa capillaire superficiel (SCP) et profond (DCP) chez des sujets sains au moyen de angiographie par tomographie par cohérence optique (OCT-A).

Méthodes : Des sujets sains consécutifs ont été inclus prospectivement en deux groupes, âgés de 18 à 29 ans pour le groupe 1 et de 30 à 40 ans pour le groupe 2. Données d'une acquisition OCT-A de 3 × 3 mm centrée sur la macula au SCP et DCP (VD, zone FAZ et FD), la fréquence cardiaque et la pression artérielle systolique-diastolique ont été recueillies avant et après un exercice physique standardisé de 20 minutes sur un vélo stationnaire.

Résultats : Les deux yeux de 32 volontaires sains ont été inclus prospectivement (15 dans le groupe 1 et 17 dans le groupe 2). L'âge moyen était de 27 ± 7 ans. Dans l'analyse globale et pour chaque groupe, une diminution de VD au niveau de SCP et une augmentation de FD au niveau de DCP étaient significatives après l'exercice. Une corrélation significative a été trouvée entre ces modifications de la vascularisation rétinienne et l'augmentation de la pression artérielle systolique induite par l'exercice. Tous les paramètres cardiovasculaires ont augmenté de manière significative avec l'exercice. Aucune différence significative n'a été trouvée entre les deux groupes, et aucun incident n'a été signalé.

Conclusions : Une corrélation significative a été établie entre les modifications cardiovasculaires systémiques (reflétées par la pression artérielle systolique) et les modifications locales de la vascularisation rétinienne au niveau de la SCP pendant l'exercice. Une période de repos pourrait être recommandée avant l'acquisition des données OCT-A, car des modifications des paramètres cardiovasculaires pourraient fausser les données vasculaires rétiniennes.