The Observation of Retinal Microvascular Alterations in Familial Hypercholesterolemia Patients through Optical Coherence Tomography Angiography

Abstract

Abstract Background: The microcirculation changes in retina of Familial hypercholesterolemia (FH) has been rarely reported previously. We evaluated fundus microvascular alterations in patients with family hypercholesterolemia (FH) through Optical Coherence Tomography Angiography. Methods: Paired sample t-test and Wilcoxon Signed-Rank Test was used to compare the differences of vessel density (VD) and retinal ultrastructure between FH patients and normal controls. The relationship between VD and serum cholesterol level in homozygous FH (HoFH) group was analyzed with multivariate lineal regression. Results: Nineteen eyes of FH patients and 19 eyes of health controls were included. Compared to controls, FH eyes had a larger foveal avascular zone area. The VDs of superficial capillary plexus (SCP) and radial peripapillary capillary (RPC) of FH patients and SCP parafoveal superior area of HoFH patients presented a significant decreasing, while VDs in subsectors of deep capillary plexus (DCP) were significantly increased in both FH group and HoFH group. VDs of SCP in whole image and the parafoveal superior area of HoFH patients were significantly related to serum cholesterol level when adjusting for age, sex, and some clinical signs. Conclusions: The fundus of FH patients demonstrated significant and characteristic microvascular alternations. VDs in some subsectors were also significantly associated with serum cholesterol level.