journal article·2025-09-26Open access

Moderate Physical Activity Generates Changes in Retina and Choroid in Low-Fit Adults

Inés López-Cuenca, Rosa de Hoz, Lorena Elvira-Hurtado, José A. Matamoros, Lidia Sanchez-Puebla, José A. Fernandez-Albarral, Ana I. Ramírez, Juan J. Salazar, José M. Ramirez, Francisco Miguel-Tobal, Elena Salobrar-Garcia

Applied Sciences· Volume 15· Issue 19

Abstract

Physical activity has been shown to influence ocular health, yet the acute effects of exercise on retinal and choroidal structures remain underexplored. This prospective pre-post study evaluated 30 low-fit adults without diagnosed cardiovascular disease who underwent comprehensive ophthalmologic assessments, including OCT and OCTA imaging, before and after a submaximal aerobic capacity test. Statistically significant thinning was observed in specific retinal sectors, affecting both inner and outer layers, including the retinal pigment epithelium (RPE). Vascular analysis using the OCTAVA toolbox revealed a significant post-exercise reduction in vessel length density, total vessel length, branchpoint density and fractal dimension in the peripapillary plexus; and mean tortuosity in the macular superficial vascular complex (SVC). Choroidal thickness also showed a significant reduction in several regions. No significant changes were found in the foveal avascular zone (FAZ). These findings suggest that acute submaximal physical activity induces transient yet measurable changes in retinal and choroidal microvasculature. The results have potential implications for understanding ocular vascular dynamics and for evaluating ocular health in clinical and sports medicine contexts.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Retinal Imaging and Analysis

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Ramon Castroviejo Institute for Ophthalmic Research, Complutense University of Madrid, 28040 Madrid, Spain

Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain

Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain

Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University of Madrid, 28037 Madrid, Spain

Department of Radiology, Rehabilitation and Physiotherapy, School of Medicine of Physical Education and Sport, School of Medicine, University Complutense of Madrid, 28040 Madrid, Spain

Funding

the Basic Vision Sciences Research Group at the IIORC · Complutense University Of Madrid

References (68)

Show source-provided references
1. Aerobic vs Anaerobic Exercise Training Effects on the Cardiovascular System10.4330/wjc.v9.i2.134 ↗
2. A Meta-Analytic Review of Aerobic Fitness and Reactivity to Psychosocial Stressors10.1249/00005768-198710001-00004 ↗
3. Demonstration of a Relationship between Level of Physical Training and Insulin-Stimulated Glucose Utilization in Normal Humans10.2337/diab.32.5.408 ↗
4. Mcardle, W.D., Katch, F.I., and Katch, V.L. (2004). Fundamentos de Fisiología del Ejercicio, McGraw-Hill Interamericana de España. [2nd ed.].
5. Association of Physical Activity with Retinal Thickness and Vascular Structure in Elderly Chinese Population10.1159/000527448 ↗
6. Physical Activity and Age-Related Macular Degeneration: A Systematic Literature Review and Meta-Analysis10.1016/j.ajo.2017.05.016 ↗
7. Physical Activity and Eye Diseases. The Beijing Eye Study10.1111/aos.13962 ↗
8. Fernandez-Rio, J., González-Villora, S., Valero-Valenzuela, A., Anton-Candanedo, A., Merino-Barrero, J.A., de los Ríos, J.V.S., and López Gajardo, M.A. (2020). Accelerometry-Measured Physical Activity in Amateur Footballers. Is It Enough to Obtain Health Benefits?. Sustainability, 12.10.3390/su12114477 ↗
9. Submaximal Exercise Testing: Clinical Application and Interpretation10.1093/ptj/80.8.782 ↗
10. Dahl, H.A., Rodahl, K., Stromme, S.B., and Åstrand, P.-O. (2003). Textbook of Work Physiology: Physiological Bases of Exercise, Human Kinetics.
11. Deporte, A. (1990). Fisiologia del Ejercicio; Energia, Nutricion y Rendimiento Humano, Lippincott Williams & Wilkins.
12. Astrand, P., Rodahl, K., Dahl, H.A., and Stromme, S.B. (2010). Manual de Fisiología del Ejercicio, Editorial Médica Panamericana.
13. Quantitative Assessment of the Effect of Acute Anaerobic Exercise on Macular Perfusion via Swept-Source Optical Coherence Tomography Angiography in Young Football Players10.1007/s10792-020-01303-w ↗
14. López Chicharro, J., and Fernández Vaquero, A. (2023). Fisiología Del Ejercicio, Panamericana. [4th ed.].
15. Fluid Intake Restores Retinal Blood Flow Early After Exhaustive Exercise in Healthy Subjects10.1007/s00421-018-3839-6 ↗
16. Li, S., Pan, Y., Xu, J., Li, X., Spiegel, D.P., Bao, J., and Chen, H. (2021). Effects of Physical Exercise on Macular Vessel Density and Choroidal Thickness in Children. Sci. Rep., 11.10.1038/s41598-021-81770-y ↗
17. Acute Effects of Exercise on Choroidal Thickness and Ocular Pulse Amplitude
18. Short-Term Effects of Exercise on Optic Nerve and Macular Perfusion Measured by Optical Coherence Tomography Angiography10.1097/IAE.0000000000001419 ↗
19. Optical Coherence Tomography Angiography as a Future Diagnostic Tool in Sports Medicine?10.1007/s00347-019-0897-z ↗
20. Optical Coherence Tomography Angiography Quantitative Assessment of Exercise-Induced Variations in Retinal Vascular Plexa of Healthy Subjects10.1167/iovs.18-24389 ↗
21. Effect of Acute High-Intensity Resistance Exercise on Optic Nerve Sheath Diameter and Ophthalmic Artery Blood Flow Pulsatility10.1038/jhh.2015.12 ↗
22. The Assessment of Acute Chorioretinal Changes Due to Intensive Physical Exercise in Senior Elite Athletes10.1123/japa.2022-0231 ↗
23. Choroidal Thickness and Volume Modifications Induced by Aerobic Exercise in Healthy Young Adults10.1159/000511201 ↗
24. Salobrar-Garcia, E., Méndez-Hernández, C., de Hoz, R., Ramírez, A.I., López-Cuenca, I., Fernández-Albarral, J.A., Rojas, P., Wang, S., García-Feijoo, J., and Gil, P. (2020). Ocular Vascular Changes in Mild Alzheimer’s Disease Patients: Foveal Avascular Zone, Choroidal Thickness, and ONH Hemoglobin Analysis. J. Pers. Med., 10.10.3390/jpm10040231 ↗
25. López-Cuenca, I., Salobrar-García, E., Sánchez-Puebla, L., Espejel, E., Del Arco, L.G., Rojas, P., Elvira-Hurtado, L., Fernández-Albarral, J.A., Ramírez-Toraño, F., and Barabash, A. (2022). Retinal Vascular Study Using OCTA in Subjects at High Genetic Risk of Developing Alzheimer’s Disease and Cardiovascular Risk Factors. J. Clin. Med., 11.10.3390/jcm11113248 ↗
26. Blood Vessel Segmentation of Fundus Retinal Images Based on Improved Frangi and Mathematical Morphology10.1155/2021/4761517 ↗
27. Yang, J., Huang, M., Fu, J., Lou, C., and Feng, C. (2020). Frangi Based Multi-Scale Level Sets for Retinal Vascular Segmentation. Comput. Methods Programs Biomed., 197.10.1016/j.cmpb.2020.105752 ↗
28. Retinal and Choroidal Blood Flow Variations after an Endurance Exercise: A Real-Life Pilot Study at the Paris Marathon10.1016/j.jsams.2021.03.013 ↗
29. OCTA Quantitative Assessment of Exercise-Induced Variations and Recovery in Retinal Microvasculature of Healthy Subjects with or without Masks10.1016/j.mvr.2024.104719 ↗
30. Retina Vascular Perfusion Dynamics During Exercise With and Without Face Masks in Healthy Young Adults: An OCT Angiography Study10.1167/tvst.10.3.23 ↗
31. Choroidal Thickness Changes after Dynamic Exercise as Measured by Spectral-Domain Optical Coherence Tomography10.4103/0301-4738.159884 ↗
32. Exercise-Induced Acute Changes in Systolic Blood Pressure Do Not Alter Choroidal Thickness as Measured by a Portable Spectral-Domain Optical Coherence Tomography Device10.1097/IAE.0b013e3182618c22 ↗
33. Ophthalmological Evaluation of Integrated Resistance and Aerobic Training During 70-Day Bed Rest10.3357/AMHP.4768.2017 ↗
34. Role of NO in Choroidal Blood Flow Regulation during Isometric Exercise in Healthy Humans10.1167/iovs.02-0177 ↗
35. Ocular Blood Flow Changes after Dynamic Exercise in Humans10.1038/sj.eye.6702004 ↗
36. Physical Exercise as Therapy for Type 2 Diabetes Mellitus10.1002/dmrr.2514 ↗
37. Lifelong Exercise Patterns and Cardiovascular Health10.1016/j.mayocp.2016.02.028 ↗
38. Comparable Effects of High-Intensity Interval Training and Prolonged Continuous Exercise Training on Abdominal Visceral Fat Reduction in Obese Young Women10.1155/2017/5071740 ↗
39. Worldwide Trends in Insufficient Physical Activity from 2001 to 2016: A Pooled Analysis of 358 Population-Based Surveys with 1·9 Million Participants10.1016/S2214-109X(18)30357-7 ↗
40. Nelis, P., Schmitz, B., Klose, A., Rolfes, F., Alnawaiseh, M., Krüger, M., Eter, N., Brand, S.M., and Alten, F. (2019). Correlation Analysis of Physical Fitness and Retinal Microvasculature by OCT Angiography in Healthy Adults. PLoS ONE, 14.10.1371/journal.pone.0225769 ↗
41. Evaluation of the Effect of High-Intensity Interval Training on Macular Microcirculation via Swept-Source Optical Coherence Tomography Angiography in Young Football Players10.4103/ijo.IJO_3079_20 ↗
42. Effects of High-Intensity Interval Training on Optic Nerve Head and Macular Perfusion Using Optical Coherence Tomography Angiography in Healthy Adults10.1016/j.atherosclerosis.2018.04.028 ↗
43. Physical Activity Is Associated With Macular Thickness: A Multi-Cohort Observational Study10.1167/iovs.64.3.11 ↗
44. Physical Activity and Cardiovascular Fitness During Childhood and Adolescence: Association With Retinal Nerve Fibre Layer Thickness in Young Adulthood10.1097/IJG.0000000000001865 ↗
45. Tun, Y.Z., and Aimmanee, P. (2023). A Complete Review of Automatic Detection, Segmentation, and Quantification of Neovascularization in Optical Coherence Tomography Angiography Images. Diagnostics, 13.10.3390/diagnostics13223407 ↗
46. Reduced Oxygen Extraction in the Retinal Periphery When the Arterial Blood Pressure Is Increased by Isometric Exercise in Normal Persons10.1167/iovs.62.3.11 ↗
47. Increased Blood Pressure Induces a Diameter Response of Retinal Arterioles That Increases with Decreasing Arteriolar Diameter10.1167/iovs.06-0360 ↗
48. Differential Effects of Nitric Oxide and Cyclo-Oxygenase Inhibition on the Diameter of Porcine Retinal Vessels with Different Caliber during Hypoxia Ex Vivo10.1016/j.exer.2017.04.001 ↗
49. Natriuretic Peptides and Their Receptors in Human Neural Retina and Retinal Pigment Epithelium
50. Existence of Atrial Natriuretic Peptide in Choroid, Retina and Ciliary Body in Rabbits
51. Immunoreactive Atrial Natriuretic Peptide in the Retina of Rats and Rabbits10.1016/0006-8993(89)91612-0 ↗
52. Natriuretic Peptide System in the Human Retina
53. Menna, F., De Luca, L., Lupo, S., Meduri, A., and Vingolo, E.M. (2025). Variations in Intraocular Pressure Among Athletes Across Different Sports Disciplines. J. Clin. Med., 14.10.20944/preprints202504.0730.v1 ↗
54. Anatomy of the Human Optic Nerve: Structure and Function
55. Optical Coherence Tomography Angiography Offers New Insights into Choriocapillaris Perfusion10.1159/000485261 ↗
56. Nonvascular Contractile Cells in Sclera and Choroid of Humans and Monkeys
57. Macular Choroidal Thickness and Volume in Normal Subjects Measured by Swept-Source Optical Coherence Tomography10.1167/iovs.11-7729 ↗
58. Choroidal Thickness and Volume in Healthy Young White Adults and the Relationships between Them and Axial Length, Ammetropy and Sex10.1016/j.ajo.2014.05.035 ↗
59. Choroidal Thickness in Healthy Japanese Subjects10.1167/iovs.09-4383 ↗
60. Kinoshita, T., Mori, J., Okuda, N., Imaizumi, H., Iwasaki, M., Shimizu, M., Miyamoto, H., Akaiwa, K., Semba, K., and Sonoda, S. (2016). Effects of Exercise on the Structure and Circulation of Choroid in Normal Eyes. PLoS ONE, 11.10.1371/journal.pone.0168336 ↗
61. Vascular Smooth Muscle Cells and Arterial Stiffening: Relevance in Development, Aging, and Disease10.1152/physrev.00003.2017 ↗
62. NPY and TH Innervation in Human Choroidal Whole-Mounts
63. Age-Related Decline in VIP-Positive Parasympathetic Nerve Fibers in the Human Submacular Choroid10.1167/iovs.06-0972 ↗
64. Sympathetic Nervous Activity during Exercise10.1146/annurev.ph.45.030183.001035 ↗
65. Cellular and Physiological Mechanisms Underlying Blood Flow Regulation in the Retina and Choroid in Health and Disease10.1016/j.preteyeres.2012.04.004 ↗
66. Potential Causes, Mechanisms, and Implications of Post Exercise Hypotension10.1038/sj.jhh.1001377 ↗
67. Reactivity of Ambulatory Blood Pressure to Physical Activity Varies with Time of Day10.1161/01.HYP.0000206421.09642.b5 ↗
68. Acute and Chronic Effects of Marathon Running on the Retinal Microcirculation10.1016/j.atherosclerosis.2011.08.052 ↗