{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:32:22Z","timestamp":1790785942653,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,9,20]],"date-time":"2014-09-20T00:00:00Z","timestamp":1411171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Hillcrest Foundation (Perpetual)"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study investigated the long\u2010term ophthalmological consequences of cyanotic congenital heart disease (<jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional study, tertiary referral setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Thirteen adults with cyanotic <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content> (40\u2009\u00b1\u20094 years). Age\u2010 and sex\u2010matched healthy controls underwent aspects of the protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cyanosed subjects had a full ophthalmic examination, visual fields, scanning laser ophthalmoscopy and optical coherence tomography to assess retinal nerve fibre layer (<jats:styled-content style=\"fixed-case\">RNFL<\/jats:styled-content>), retinal photography and cerebral magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">RNFL<\/jats:styled-content> thickness and quantitative analysis of retinal vessels with fractal dimension, branching and central retinal arterial equivalent (<jats:styled-content style=\"fixed-case\">CRAE<\/jats:styled-content>) and central retinal venous equivalent (<jats:styled-content style=\"fixed-case\">CRVE<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No abnormalities of anatomy, motility, intraocular pressure or anterior segments were detected apart from one subject who had bilateral cataracts. Corrected visual acuity was normal in all but one cyanosed subject. Clinical examination revealed dilated retinal vasculature in 12\/13 cyanosed subjects and increased tortuosity in 8\/13. In the setting of cyanosis, skeletonized retinal arterial and venous beds had higher fractal dimension and increased branching (<jats:italic>P<\/jats:italic>\u2009\u2264\u20090.01, <jats:italic>n<\/jats:italic>\u2009=\u200911 for all); retinal vessels were dilated (<jats:styled-content style=\"fixed-case\">CRAE<\/jats:styled-content>: 227 <jats:italic>vs<\/jats:italic>. 183, <jats:italic>n<\/jats:italic>\u2009=\u200911, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001; <jats:styled-content style=\"fixed-case\">CRVE<\/jats:styled-content>: 254 <jats:italic>vs<\/jats:italic>. 221, <jats:italic>n<\/jats:italic>\u2009=\u200911, <jats:italic>P<\/jats:italic>\u2009=\u20090.01). Visual fields showed scotomas in two subjects associated with <jats:styled-content style=\"fixed-case\">RNFL<\/jats:styled-content> thinning. No disc oedema was detected. 6\/13 subjects\u2019 <jats:styled-content style=\"fixed-case\">RNFL<\/jats:styled-content> thickness fell below the normal 95% confidence interval in at least one sector without explanatory cerebral pathology (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001, <jats:italic>n<\/jats:italic>\u2009=\u200913). Mean <jats:styled-content style=\"fixed-case\">RNFL<\/jats:styled-content> thickness correlated with <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> cerebral white matter volume (R\u2009=\u20090.67, <jats:italic>P<\/jats:italic>\u2009=\u20090.035).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cyanosed subjects had vessel dilatation, increased branching and tortuosity. <jats:styled-content style=\"fixed-case\">RNFL<\/jats:styled-content> and visual field thresholds were reduced suggesting impaired neuro\u2010ophthalmological functioning.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.12401","type":"journal-article","created":{"date-parts":[[2014,7,31]],"date-time":"2014-07-31T04:13:42Z","timestamp":1406780022000},"page":"115-123","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Ophthalmological consequences of cyanotic congenital heart disease: vascular parameters and 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