Abstract：
OBJECTIVE: Functional hypothalamic amenorrhea (FHA) is characterized by an estrogen deficiency which in turn can cause vascular dysfunction. The aim of this study is to evaluate any changes in the chorio-retinal circulation in patients affected by FHA. 24 patients with FHA and 24 age-matched controls underwent a gynecological evaluation and an OCT angiography (OCTA) to study chorio-retinal vascularization.
RESULTS: OCTA in FHA patients showed an increase in vessel density in the choriocapillaris (CC) layer (both in the fovea area, at 5% p value = 0.037 and in the whole area, at 5% p value = 0.028) and an increase in vascular density in the deep fovea (DVP) (at 10% p value = 0.096) in the whole district compared to controls. Simple linear regressions show a significant negative association between CC vessel density and insulin (p = 0.0002) and glucose values (p = 0.0335) for the fovea district and a negative association between DVP vessel density and endometrial thickness (at 10%, p value: 0.095) in the whole district.
CONCLUSIONS: Our study shows that CC vessel density is increased in women affected by FHA. This could represent a compensation effort to supply the vascular dysfunction caused by estrogen deficiency. We also found an increasing trend in vascular density in DVP associated with the decrease of endometrial thickness, an indirect sign of estrogenization. Considering that these changes occur in absence of visual defects, they could be used as a biomarker to estimate hypoestrogenism-induced microcirculation changes before clinical appearance.
RESULTS: OCTA in FHA patients showed an increase in vessel density in the choriocapillaris (CC) layer (both in the fovea area, at 5% p value = 0.037 and in the whole area, at 5% p value = 0.028) and an increase in vascular density in the deep fovea (DVP) (at 10% p value = 0.096) in the whole district compared to controls. Simple linear regressions show a significant negative association between CC vessel density and insulin (p = 0.0002) and glucose values (p = 0.0335) for the fovea district and a negative association between DVP vessel density and endometrial thickness (at 10%, p value: 0.095) in the whole district.
CONCLUSIONS: Our study shows that CC vessel density is increased in women affected by FHA. This could represent a compensation effort to supply the vascular dysfunction caused by estrogen deficiency. We also found an increasing trend in vascular density in DVP associated with the decrease of endometrial thickness, an indirect sign of estrogenization. Considering that these changes occur in absence of visual defects, they could be used as a biomarker to estimate hypoestrogenism-induced microcirculation changes before clinical appearance.
摘要：
目的：功能性下丘脑闭经（FHA）的特征是雌激素缺乏，进而导致血管功能障碍。这项研究的目的是评估受FHA影响的患者的脉络膜-视网膜循环的任何变化。24名FHA患者和24名年龄匹配的对照者接受了妇科评估和OCT血管造影（OCTA）以研究绒毛膜视网膜血管形成。
结果：FHA患者的OCTA显示脉络膜毛细血管（CC）层的血管密度增加（均在中央凹区域，在5%p值=0.037时，在整个区域，与对照组相比，在5％p值=0.028）和整个地区深中央凹（DVP）的血管密度增加（在10％p值=0.096）。简单的线性回归显示，中央凹区域的CC血管密度与胰岛素（p=0.0002）和葡萄糖值（p=0.0335）之间存在显着负相关，而DVP血管密度与子宫内膜厚度之间存在负相关（在10％，整个地区的p值：0.095）。
结论：我们的研究表明，受FHA影响的女性CC血管密度增加。这可能代表一种补偿努力，以提供由雌激素缺乏引起的血管功能障碍。我们还发现DVP中血管密度的增加趋势与子宫内膜厚度的减少有关，雌激素化的间接标志。考虑到这些变化发生在没有视觉缺陷的情况下，它们可以作为一种生物标志物,在临床出现前评估雌激素不足引起的微循环改变.
结果：FHA患者的OCTA显示脉络膜毛细血管（CC）层的血管密度增加（均在中央凹区域，在5%p值=0.037时，在整个区域，与对照组相比，在5％p值=0.028）和整个地区深中央凹（DVP）的血管密度增加（在10％p值=0.096）。简单的线性回归显示，中央凹区域的CC血管密度与胰岛素（p=0.0002）和葡萄糖值（p=0.0335）之间存在显着负相关，而DVP血管密度与子宫内膜厚度之间存在负相关（在10％，整个地区的p值：0.095）。
结论：我们的研究表明，受FHA影响的女性CC血管密度增加。这可能代表一种补偿努力，以提供由雌激素缺乏引起的血管功能障碍。我们还发现DVP中血管密度的增加趋势与子宫内膜厚度的减少有关，雌激素化的间接标志。考虑到这些变化发生在没有视觉缺陷的情况下，它们可以作为一种生物标志物,在临床出现前评估雌激素不足引起的微循环改变.
