UTJECAJ VJEŽBANJA I RAZINE OSPOSOBLJENOSTI NA MIKROCIRKULACIJU RETINE

Aim: To examine differences in retinal microcirculation between people with different degrees of physical fi tness. Methods: The subjects were divided into athletes and non-athletes. Both groups took part in two examinations. The fi rst examination was performed before short-term exercise and the second one immediately after it. First group consisted of 25 athletes (50 eyes), and the second group of 25 non-athletes (50 eyes) who were not previously exposed to acute physical stress. Athletes are defi ned as people who have been engaged in some form of regular physical activity for at least 5 years, and have met certain criteria according to the International Physical Activity Questionnaire (IPAQ). Non-athletes were those who were physically inactive or at least not regularly engaged in physical activity during the same period and did not meet the IPAQ criteria. The subjects were men and women between 18 and 26 years of age who did not have any cardiovascular disease, used drugs affecting the cardiovascular system, nor had an eye disease or a refractive error greater than spherical equivalent of +/-3 diopters. The examination consisted of optical coherence tomography angiography (OCT-A) imaging pre- and post-workout. The parameters taken into account were vascular density (VD) at three different macular areas according to the standard Early Treatment Diabetic Retinopathy Study (ETDRS) grid, i.e., central zone, inner zone and full area; perfusion density (PD), also at the three mentioned zones; and the area of foveal avascular zone (FAZ) in both eyes. The research also included a standardized survey on physical activity of the subjects (IPAQ), which was completed before the examination. The acute physical exercise consisted of the standardized incremental cycling ergometer test (ICET), which was performed on a stationary exercise bike for 5 minutes, at a given load of 12 degrees. On statistical processing of the data obtained, SPSS for Windows (version 13.0, SPSS Inc., Chicago, Illinois, USA) software was used. Results: Baseline measures of VD and PD were similar between the groups. FAZ surface was signifi cantly increased in the athlete group compared with non-athletes both at baseline and after short-term exercise. VD was signifi cantly higher in athletes post-exercise compared with the non-athlete group. Central PD was also signifi -cantly increased after exercise in the athlete group, and not in the non-athlete group. Conclusion: The results obtained in this study demonstrated that athletes exhibited a more intensive vascular reaction to exercise. The parameters in basal conditions did not show signifi cant difference between the two groups, except for FAZ which was larger in athletes. Signifi cant differences present post-workout in other measured values indicated a more dynamic vascular system in physically active individuals.ilj rada: Ispitati razlike u retinalnoj mikrocirkulaciji između osoba s višim i nižim stupnjem tjelesne osposobljenosti. Postupci: Ispitanici su bili podijeljeni na sportaše i nesportaše. Obje skupine pristupile su dvama odvojenim mjerenjima. Prvi pregled obavljen je prije fi zičkog opterećenja, a drugi neposredno nakon njega. Prvu skupinu činilo je 25 sportaša (50 očiju), a drugu 25 nesportaša (50 očiju) koji prethodno nisu bili izloženi akutnom fi zičkom stresu. Sportaše defi niramo kao osobe koje se najmanje 5 godina bave nekim oblikom redovite tjelesne aktivnosti u obliku treniranja nekog sporta, fi tnesa, aerobnog treninga i sl. te ispunjavaju određene uvjete prema međunarodnom upitniku o tjelesnoj aktivnosti (International Physical Activity Questionnaire, IPAQ). Neki sportaši nisu bili fi zički aktivni ili barem ne redovito tijekom istog razdoblja i nisu ispunjavali navedene kriterije IPAQ. Ispitanici su bili muškarci i žene u dobi između 18 i 26 godina koji nisu imali nikakvu srčanožilnu bolest, nisu uzimali lijekove koji utječu na srčanožilni sustav niti su imali ikakvu bolest očiju ili refraktivnu grešku veću od sfernog ekvivalenta +/-3 dioptrije. Prikupljanje podataka provedeno je pomoću optičke koherentne tomografske angiografi je (OCT-A). Analizirani su sljedeći parametri: vaskularna gustoća (VG) u tri različita područja makule prema mreži ETDRS (Early Treatment Diabetic Retinopathy Study): središnja zona, unutarnja zona i puna zona; perfuzijska gustoća (PG), također u tri navedena područja; te površina fovealne avaskularne zone (FAZ). Istraživanje je uključivalo i standardiziranu anketu o tjelesnoj aktivnosti ispitanika (IPAQ) koja se ispunjavala prije samog pregleda. Fizičko opterećenje sastojalo se od standardiziranog testa ICET (incremental cycling ergometer test), koji se izvodio na stacionarnom sobnom biciklu u trajanju od 5 minuta pri zadanom opterećenju od 12 stupnjeva, nakon čega su ispitanicima izmjereni puls i saturacija. Također, prije same vježbe ispitanicima su izmjerene srčana frekvencija i saturacija u mirovanju. Za statističku obradu dobivenih podataka primijenjen je softverski sustav SPSS for Windows (verzija 13.0, SPSS Inc., Chicago, Illinois, SAD). Rezultati: Mjerenja u bazalnim uvjetima pokazala su slične vrijednosti VGi PG između skupina. Površina FAZ bila je statistički značajno veća u skupini sportaša u usporedbi s nesportašima i u bazalnim uvjetima i nakon tjelovježbe. Nakon tjelovježbe VG i središnji PG pokazali su statistički značajno povećanje u sportaša, dok u nesportaša nije bilo razlike prije i nakon tjelovježbe. Zaključak: Rezultati dobiveni u ovoj studiji pokazali su da sportaši imaju intenzivniju vaskularnu reakciju na vježbanje. Parametri u bazalnim uvjetima nisu pokazali značajnu razliku između dviju skupina osim za FAZ, koja je bila veća u sportaša. Značajne razlike bile su prisutne nakon treninga u drugim izmjerenim vrijednostima i ukazuju na dinamičniji vaskularni sustav u fi zički aktivnih pojedinaca