The Effect of Physical Exercise on the Retina and Choroid

Abstract

There is only limited information available on the effects of physical exercise on the posterior pole. Retinal circulation is autoregulated similarly to the brain vasculature in order to provide constant flow and thus constant nutrition of the inner retinal structures while the choroid is mostly controlled by the sympathetic nervous system. The available data show that physical exercise may indeed have a positive effect on the retina and visual function. The assessment of retinal structure could serve as a marker in sports medicine, whereas physical activity could exert a positive protective effect against diseases such as diabetic retinopathy or age-related macular degeneration. According to our theory, similar to the term “trained heart” used in cardiology and sports medicine, the term “trained eye” could also be coined. This latter term would help to further emphasize the beneficial effects of physical exercise that works protectively not only for the cardiovascular but for the visual system as well, and thus could further help in the fight against avoidable blindness worldwide.

Zusammenfassung

Es ist nur relativ wenig Information über die Wirkung der körperlichen Aktivität auf den hinteren Augenabschnitt vorhanden. Die Netzhautzirkulation wurde ähnlich zum Gehirn durch Autoregulation geregelt, welche die Ernährung der inneren Netzhautschichten ermöglicht, wobei die Aderhaut primär durch die sympathetische Innervation gesteuert wurde. Die zur Verfügung stehenden Informationen zeigen, dass körperliche Aktivität eine positive Auswirkung auf die Netzhaut und Sehleistung haben kann. Die strukturellen Angaben der Netzhaut könnten als Marker in der Sportmedizin dienen und körperliche Aktivität wirkt vermutlich sehr stark protektiv bei Krankheiten wie diabetischer Retinopathie und altersbedingter Makuladegeneration. Nach unserer Theorie, ähnlich zum „trainierten Herz“ in der Sportmedizin und Kardiologie, könnte man auch das „trainierte Auge“ als Definition einführen, welche auf die positive, protektive Wirkung der körperlichen Aktivität bei verschiedenen Krankheiten hinweist. Dies könnte den Kampf gegen die vermeidbare Erblindung weiter unterstützen.

Key words

choroid - retina - optical coherence tomography - physical exercise

Schlüsselwörter

Chorioidea - Retina - optische Kohärenztomografie - körperliche Aktivität

• References

• 1 Leasher JL, Bourne RR, Flaxman SR. et al. Global estimates on the number of people blind or visually impaired by diabetic retinopathy: a meta-analysis from 1990 to 2010. Diabetes Care 2016; 39: 1643-1649 doi:10.2337/dc15-2171
• 2 Hulke SM, Phatak MS, Vaidya YP. Cardiorespiratory response to aerobic exercise programs with different intensity: 20 weeks longitudinal study. J Res Med Sci 2012; 17: 649-655
• 3 Koller A, Toth P. Contribution of flow-dependent vasomotor mechanisms to the autoregulation of cerebral blood flow. J Vasc Res 2012; 49: 375-389 doi:10.1159/000338747
• 4 Boltz A, Schmidl D, Werkmeister RM. et al. Regulation of optic nerve head blood flow during combined changes in intraocular pressure and arterial blood pressure. J Cereb Blood Flow Metab 2013; 33: 1850-1856 doi:10.1038/jcbfm.2013.137
• 5 Nemeth J, Knezy K, Tapaszto B. et al. Different autoregulation response to dynamic exercise in ophthalmic and central retinal arteries: a color Doppler study in healthy subjects. Graefes Arch Clin Exp Ophthalmol 2002; 240: 835-840 doi:10.1007/s00417-002-0552-1
• 6 Metelitsina TI, Grunwald JE, DuPont JC. et al. Effect of isometric exercise on choroidal blood flow in patients with age-related macular degeneration. Br J Ophthalmol 2010; 94: 1629-1631 doi:10.1136/bjo.2009.176859
• 7 Vo Kim S, Semoun O, Pedinielli A. et al. Optical coherence tomography angiography quantitative assessment of exercise-induced variations in retinal vascular plexa of healthy subjects. Invest Ophthalmol Vis Sci 2019; 60: 1412-1419 doi:10.1167/iovs.18-24389
• 8 Alnawaiseh M, Lahme L, Treder M. et al. Short-term effects of exercise on optic nerve and macular perfusion measured by optical coherence tomography angiography. Retina 2017; 37: 1642-1646 doi:10.1097/IAE.0000000000001419
• 9 Pressler A, Hanssen H, Dimitrova M. et al. Acute and chronic effects of marathon running on the retinal microcirculation. Atherosclerosis 2011; 219: 864-868 doi:10.1016/j.atherosclerosis.2011.08.052
• 10 Nussbaumer M, Donath L, Fischer M. et al. Effects of acute bouts of endurance exercise on retinal vessel diameters are age and intensity dependent. Age (Dordr) 2014; 36: 9650 doi:10.1007/s11357-014-9650-3
• 11 Lundberg K, Tarp J, Vestergaard AH. et al. Retinal vascular diameters in relation to physical activity in Danish children – The CHAMPS Eye Study. Scand J Med Sci Sports 2018; 28: 1897-1907 doi:10.1111/sms.13204
• 12 Alten F, Nelis P, Schmitz B. et al. [Optical coherence tomography angiography as a future diagnostic tool in sports medicine?]. Ophthalmologe 2019; 116: 722-727 doi:10.1007/s00347-019-0897-z
• 13 Schmitz B, Nelis P, Rolfes F. et al. Effects of high-intensity interval training on optic nerve head and macular perfusion using optical coherence tomography angiography in healthy adults. Atherosclerosis 2018; 274: 8-15 doi:10.1016/j.atherosclerosis.2018.04.028
• 14 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: 160-165 doi:10.1097/IAE.0b013e3182618c22
• 15 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: e0168336 doi:10.1371/journal.pone.0168336
• 16 Sayin N, Kara N, Pekel G. et al. Choroidal thickness changes after dynamic exercise as measured by spectral-domain optical coherence tomography. Indian J Ophthalmol 2015; 63: 445-450 doi:10.4103/0301-4738.159884
• 17 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: 371-378 doi:10.1111/aos.13640
• 18 Lundberg K, Suhr Thykjaer A, Sogaard Hansen R. et al. Physical activity and myopia in Danish children-The CHAMPS eye study. Acta Ophthalmol 2018; 96: 134-141 doi:10.1111/aos.13513
• 19 Popa-Cherecheanu A, Schmidl D, Werkmeister RM. et al. Regulation of choroidal blood flow during isometric exercise at different levels of intraocular pressure. Invest Ophthalmol Vis Sci 2019; 60: 176-182 doi:10.1167/iovs.18-24992
• 20 Lawson EC, Han MK, Sellers JT. et al. Aerobic exercise protects retinal function and structure from light-induced retinal degeneration. J Neurosci 2014; 34: 2406-2412 doi:10.1523/JNEUROSCI.2062-13.2014
• 21 Chrysostomou V, Kezic JM, Trounce IA. et al. Forced exercise protects the aged optic nerve against intraocular pressure injury. Neurobiol Aging 2014; 35: 1722-1725 doi:10.1016/j.neurobiolaging.2014.01.019
• 22 Zhang X, Girardot PE, Sellers JT. et al. Wheel running exercise protects against retinal degeneration in the I307N rhodopsin mouse model of inducible autosomal dominant retinitis pigmentosa. Mol Vis 2019; 25: 462-476
• 23 Pardue MT, Chrenek MA, Schmidt RH. et al. Potential role of exercise in retinal health. Prog Mol Biol Transl Sci 2015; 134: 491-502 doi:10.1016/bs.pmbts.2015.06.011
• 24 Kim DY, Jung SY, Kim CJ. et al. Treadmill exercise ameliorates apoptotic cell death in the retinas of diabetic rats. Mol Med Rep 2013; 7: 1745-1750 doi:10.3892/mmr.2013.1439
• 25 Braun G, Hafner B, Konigstein K. et al. Association of cardiorespiratory fitness with retinal vessel diameters as a biomarker of cardiovascular risk. Microvasc Res 2018; 120: 36-40 doi:10.1016/j.mvr.2018.06.001
• 26 Williams PT. Prospective study of incident age-related macular degeneration in relation to vigorous physical activity during a 7-year follow-up. Invest Ophthalmol Vis Sci 2009; 50: 101-106 doi:10.1167/iovs.08-2165
• 27 Guthold R, Ono T, Strong KL. et al. Worldwide variability in physical inactivity a 51-country survey. Am J Prev Med 2008; 34: 486-494 doi:10.1016/j.amepre.2008.02.013
• 28 WHO Guidelines Approved by the Guidelines Review Committee. In Global Recommendations on Physical Activity for Health. Geneva: WHO Press; 2010