Evaluation of Choroidal Vascularity Index, Retinal and Optic Nerve Changes in Erectile Dysfunction

Abstract Objective: To investigate choroidal alterations through assessment of subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI), optic nerve modifications through evaluation of peripapillary retinal nerve fiber layer (RNFL), and macular changes through assessment of ganglion cell layer (GCL) in patients with erectile dysfunction, and to compare these parameters with age-matched healthy controls. Methods: This cross-sectional study included 30 eyes of 30 patients diagnosed with erectile dysfunction based on the International Index of Erectile Function (IIEF-15) questionnaire. Spectral-domain optical coherence tomography (SD-OCT) was employed to evaluate peripapillary RNFL and GCL thickness. OCT images were acquired and processed using the Image-J software to calculate CVI. All measurements were compared with those obtained from 30 age-matched healthy volunteers. Results: RNFL thickness values in the inferior, superior and nasal quadrants and CVI values were found to be statistically significantly lower in the erectile dysfunction group compared to the control group (p<0.001, p=0.006, p<0.001, p<0.001). GCL thickness values in all quadrants and SFCT values were observed to be lower in the erectile dysfunction group compared to the control group. However, the difference was not statistically significant. In addition, a moderate positive correlation was found between the CVI and erectile function (r=0.473, p=0.008). Conclusions: RNFL and CVI may be valuable markers in addition to questionnaires in the diagnosis of erectile dysfunction. Furthermore, due to the rapid, repeatable and non-invasive nature of the SD-OCT device, RNFL and CVI measurements may act as predictive factors in erectile dysfunction.