Uzun süreli düzenli egzersiz ve retinokoroidal yapı değişiklikleri: gerçek yaşam verilerl üzerine bir çalışma

Year 2025, Volume: 7 Issue: 5, 635 - 641, 15.09.2025

Nur Demir , Hasine Gözde Dalkılıç , Belma Kayhan , Nurgül Tükel , Zeliha Serindağ , Mustafa Kaplan

https://doi.org/10.38053/acmj.1757798

Abstract

Amaç: Egzersiz göz kan perfüzyon basıncını artırır. Retina ve koroid, kan akışını belirli bir dereceye kadar otoregüle eder. Çalışmaların çoğu egzersizin kısa süreli oftalmolojik etkilerine odaklanmış ve çelişkili sonuçlar göstermiştir. Bu çalışma, egzersizin retina ve koroid üzerindeki etkilerini ve egzersizle değişen sistemik parametrelerin ek katkısını değerlendirmeyi amaçlamaktadır.
Yöntem: En az 2 yıl egzersiz yapan katılımcılar çalışma grubunu ve egzersiz yapmayanlar kontrol grubunu oluşturdu. Kan basıncı, kalp hızı, vücut kitle indeksi, HbA1c, tam kan sayımı, lipid profili, tiroid uyarıcı hormon, serbest T4, serbest T3 ve C-reaktif protein analiz edildi. Sağ gözlerin retina katmanları ve koroidal kalınlıkları optik koherens tomografi ile değerlendirildi.
Bulgular: Egzersiz yapan grup 36, kontrol grubu ise 35 katılımcıdan oluşuyordu. Düzenli egzersiz yapılan süre ortalaması 4,29±2,5 yıldı. Koroid kalınlığı, egzersiz grubunda, kontrol grubuna kıyasla nazal (p<0,05) ve subfoveal makula alanlarında istatistiksel olarak anlamlıydı (p<0,01), bununla birlikte tüm alanlarda artış gösterdi. Hematolojik parametrelerde, egzersiz grubunda istatistiksel olarak anlamlı artış saptandı.
Sonuç: Bu çalışma, gerçek yaşam koşullarında, uzun dönem düzenli egzersizden sonra oluşan retina ve koroid değişikliklerini bildiren ilk çalışmadır. Koroidin anlamlı olarak kalınlaşması, egzersiz sırasında artan oküler perfüzyon basıncının, uzun süreli spor aktivitesi sırasında zaman zaman koroid otoregülasyonunun düzenleyici kapasitesini aşabileceğini göstermektedir.

Keywords

Egzersiz , gerçek yaşam koşulları , hematolojik parametreler , kardiyovasküler risk faktörleri , koroid , retina

Ethical Statement

Etik Kurul Onayı alındı ve yüklendi

Long-term regular exercise effect on retinal and choroidal structure: insights from real-life data

Abstract

Aims: Exercise increases ocular perfusion pressure. The retina and choroid can autoregulate blood flow to a certain extent in response to this increase. Most of the studies have focused on short-term ophthalmologic effects of exercise and showed conflicting results. This study aimed to evaluate the long-term effects of regular exercise on retinal and choroidal structures, as well as the potential contribution of exercise-related systemic changes.
Methods: Participants who had engaged in regular exercise for at least two years were included in the study group, while those who had not exercised were assigned to the control group. Clinical assessments included blood pressure, heart rate, body-mass index, HbA1c, complete blood count, lipid profile, thyroid-stimulating hormone, fT3, fT4, and C-reactive protein. Retinal and choroidal thicknesses in the right eye were measured using optical coherence tomography.
Results: The trained group consisted of 36 participants and the untrained group included 35 participants. The mean duration of regular exercise was 4.29±2.5 years. Choroidal thickness was greater at all measured points in the trained group compared with controls, with significant differences at nasal (p<0.05) and subfoveal (p<0.01) measurements. Red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and eosinophil counts were also significantly higher in the trained group.
Conclusion: This study is, to our knowledge, the first to investigate the effects of long-term, consistent physical activity by non professionals in real-life settings on retinal and choroidal structures. Choroidal autoregulation normally maintains stable blood flow even when ocular perfusion pressure rises during exercise. However, the observed long-term choroidal thickening suggests that prolonged physical activity may exceed this regulatory capacity.

Keywords

Cardiovascular risk factors , choroid , exercise , hematological parameters , real-life conditions , retina

Ethical Statement

Etik Kurul Onayı alındı.

References

• Szalai I, Csorba A, Pálya F, et al. The assessment of acute chorioretinal changes due to intensive physical exercise in young adults. PLoS One. 2022;17(5):e0268770. doi:10.1371/journal.pone.0268770
• Risner D, Ehrlich R, Kheradiya NS, Siesky B, McCranor L, Harris A. Effects of exercise on intraocular pressure and ocular blood flow: a review. J Glaucoma. 2009;18(6):429-436. doi:10.1097/IJG.0b013e31818fa5f3
• Vo Kim S, Semoun O, Pedinielli A, Jung C, Miere A, Souied EH. Optical coherence tomography angiography quantitative assessment of exercise-induced variations in retinal vascular plexa of healthy subjects. Invest Ophthalmol Vis Sci. 2019;60(5):1412-1419. doi:10.1167/iovs.18-24389
• Luo X, Shen YM, Jiang MN, Lou XF, Shen Y. Ocular blood flow autoregulation mechanisms and methods. J Ophthalmol. 2015;2015: 864871. doi:10.1155/2015/864871
• Yeung SC, You Y, Howe KL, Yan P. Choroidal thickness in patients with cardiovascular disease: a review. Surv Ophthalmol. 2020;65(4):473-486. doi:10.1016/j.survophthal.2019.12.007
• Yumusak E, Ciftci A, Yalcin S, Sayan CD, Dikel NH, Ornek K. Changes in the choroidal thickness in reproductive-aged women with iron-deficiency anemia. BMC Ophthalmol. 2015;15(1):186. doi:10.1186/s 12886-015-0163-3
• Fleenor BS, Marshall KD, Durrant JR, Lesniewski LA, Seals DR. Arterial stiffening with ageing is associated with transforming growth factor-β1-related changes in adventitial collagen: reversal by aerobic exercise. J Physiol. 2010;588(Pt 20):3971-3982. doi:10.1113/jphysiol.2010.194753
• Nystoriak MA, Bhatnagar A. Cardiovascular effects and benefits of exercise. Front Cardiovasc Med. 2018;5(135):11. doi:10.3389/fcvm.2018.00135
• Pedersen BK, Saltin B. Exercise as medicine-evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015;25(Suppl 3):1-72. doi:10.1111/sms.12581
• Gale J, Wells AP, Wilson G. Effects of exercise on ocular physiology and disease. Surv Ophthalmol. 2009;54(3):349-355. doi:10.1016/j.survophthal.2009.02.005
• Popa-Cherecheanu A, Schmidl D, Werkmeister RM, Chua J, Garhöfer G, Schmetterer L. Regulation of choroidal blood flow during isometric exercise at different levels of intraocular pressure. Invest Ophthalmol Vis Sci. 2019;60(1):176-182. doi:10.1167/iovs.18-24992
• Lovasik JV, Kergoat H, Riva CE, Petrig BL, Geiser M. Choroidal blood flow during exercise-induced changes in the ocular perfusion pressure.Invest Ophthalmol Vis Sci. 2003;44(5):2126-2132. doi:10.1167/iovs.02-0825
• Baek J, Kook L, Lee WK. Choriocapillaris flow impairments in association with pachyvessel in early stages of pachychoroid. Sci Rep. 2019;9(1):5565. doi:10.1038/s41598-019-42052-w
• Pressler A, Hanssen H, Dimitrova M, Krumm M, Halle M, Scherr J. Acute and chronic effects of marathon running on the retinal microcirculation. Atherosclerosis. 2011;219(2):864-868. doi:10.1016/j.atherosclerosis.2011.08.052
• Alwassia AA, Adhi M, Zhang JY, et al. Exercise-induced acute changes in systolic blood pressure do not alter choroidal thickness as measured by a portable spectral-domain optical coherence tomography device. Retina. 2013;33(1):160-165. doi:10.1097/IAE.0b013e3182618c22
• Kinoshita T, Mori J, Okuda N, et al. Effects of exercise on the structure and circulation of choroid in normal eyes. PLoS One. 2016;11(12):e0168336. doi:10.1371/journal.pone.0168336
• Sayin N, Kara N, Pekel G, Altinkaynak H. Choroidal thickness changes after dynamic exercise as measured by spectral-domain optical coherence tomography. Indian J Ophthalmol. 2015;63(5):445-450. doi: 10.4103/0301-4738.159884
• Lundberg K, Vestergaard AH, Jacobsen N, et al. Choroidal thickness and myopia in relation to physical activity-the CHAMPS eye study. Acta Ophthalmol. 2018;96(4):371-378. doi:10.1111/aos.13640
• Tsakiris TS, Konstantopoulos AI, Bourdas DI. The role of CO2 on respiration and metabolism during hypercapnic and normocapnic recovery from exercise. Res Q Exerc Sport. 2021;92(3):537-548. doi:10.1080/ 02701367.2020.1756196
• Ikemura T, Hayashi N. Ocular circulatory responses to exhaustive exercise in humans. Eur J Appl Physiol. 2012;112(9):3313-3318. doi:10. 1007/s00421-012-2313-0
• Zhu H, Liu C, Gao M, Zhang S, Zhang L, Zhao Q. Choroidal thickness in relation to diopter and axial length among myopic children. Front Med (Lausanne). 2023;10:1241352. doi:10.3389/fmed.2023.1241352
• Wardyn GG, Rennard SI, Brusnahan SK, et al. Effects of exercise on hematological parameters, circulating side population cells, and cytokines. Exp Hematol. 2008;36(2):216-223. doi:10.1016/j.exphem.2007. 10.003
• Cicek G. The effects of different exercise types on hematological parameters in sedentary women. J Educ Training Studies. 2018;6(8):96. doi:10.11114/jets.v6i8.3374
• Alam T, Rahman SM, Alam T, et al. Effect of physical exercise on some hematological parameters in female athletes in Bangladesh. JNMA J Nepal Med Assoc. 2014;52(195):892-896.
• Bizjak DA, Tomschi F, Bales G, et al. Does endurance training improve red blood cell aging and hemorheology in moderate-trained healthy individuals? J Sport Health Sci. 2020;9(6):595-603. doi:10.1016/j.jshs. 2019.02.002
• Li XQ, Larsen M, Munch IC. Subfoveal choroidal thickness in relation to sex and axial length in 93 Danish university students. Invest Ophthalmol Vis Sci. 2011;52(11):8438-8441. doi:10.1167/iovs.11-8108
• Okonkwo ON, Hassan AO, Oyekunle I, Akanbi T, Chinedu UB. Choroidal thickness and effect of sex and age in Africans. Ann Afr Med. 2023;22(4):489-496. doi:10.4103/aam.aam_184_22
• Domej W, Schwaberger G, Tilz GP, et al. Prolonged endurance challenge at moderate altitude: effect on serum eosinophil cationic protein, eosinophil dynamics, and lung function. Chest. 2002;121(4):1111-1116. doi:10.1378/chest.121.4.1111
• Dufaux B, Heine O, Prinz U, Soll C, Rost R. Effect of a short maximal physical exercise on the eosinophil cationic protein. Int J Sports Med. 1993;14(8):468-470. doi:10.1055/s-2007-1021213
• O'Donovan G, Owen A, Bird SR, et al. Changes in cardiorespiratory fitness and coronary heart disease risk factors following 24 wk of moderate- or high-intensity exercise of equal energy cost. J Appl Physiol (1985). 2005;98(5):1619-1625. doi:10.1152/japplphysiol.01310.2004
• Cardoso CG Jr, Gomides RS, Queiroz AC, et al. Acute and chronic effects of aerobic and resistance exercise on ambulatory blood pressure. Clinics (Sao Paulo). 2010;65(3):317-325. doi:10.1590/S1807-59322010000300013