Abstract
Background: Subretinal drusenoid deposits (SDDs), a hallmark of age-related macular degeneration (AMD), have been linked to cardiovascular disease, but the underlying mechanism remains unclear. We investigated the association between SDDs and severe aortic stenosis (AS).
Methods: A total of 96 patients with low-flow (LF) severe AS underwent ophthalmologic evaluation to determine SDD status. All patients underwent transthoracic echocardiography and were classified into classical low-flow low-gradient (cLFLG), paradoxical low-flow low-gradient (pLFLG), or high-gradient low-flow (HGLF) AS. Echocardiographic measurements included peak aortic jet velocity (Vmax), mean aortic gradient (MG), cardiac index (CI), and Society of Thoracic Surgeons (STS) score. Group comparisons were performed using ANOVA, t-tests, and Fisher’s exact test.
Results: Among 96 patients with severe AS who underwent comprehensive ophthalmologic evaluation, SDDs were present in 54 (56%). Compared with patients without SDD, those with SDD were older (P=0.04), had a higher prevalence of AMD (P<0.001), and had higher STS scores (P=0.04). Patients with SDD demonstrated lower peak aortic velocity, peak and mean transvalvular gradients, and cardiac index (all P≤0.04). The distribution of AS hemodynamic subtypes did not differ between groups.
Conclusions: In patients with severe AS, SDDs were associated with lower transvalvular flow and gradient indices, supporting low-flow physiology as a potential mechanism underlying SDD development.
Keywords
Subretinal drusenoid deposit, Aortic stenosis, Transcatheter aortic valve replacement, Age related macular degeneration, Retina, Choroid