Impact of Androgen Deprivation Therapy on Choroidal Microcirculation Assessed Using Laser Speckle Flowgraphy.

OBJECTIVE

To determine whether androgen deprivation therapy (ADT) alters laser speckle flowgraphy (LSFG)-detectable choroidal microvascular dynamics: mean blur rate (MBR, blood flow) and beat strength over MBR (BOM, microvascular resistance). We also investigated whether such changes emerge even when cardio-ankle vascular index (CAVI)-assessed large-artery stiffness remains unchanged.

METHODS

This study included 17 right eyes of 17 men with prostate cancer. Serum testosterone, CAVI, and choroidal parameters (MBR, BOM) were obtained at baseline and 6 months post-ADT. Central choroidal thickness (CCT) and ocular perfusion pressure (OPP) were also recorded.

RESULTS

Serum testosterone significantly decreased (4.45 ± 1.96 to 0.20 ± 0.08 ng/mL; p < 0.001) after 6 months. Choroidal BOM increased significantly (0.94 ± 0.31 to 1.11 ± 0.31; p = 0.028), whereas CAVI (10.70 ± 1.28 to 10.68 ± 1.19), choroidal MBR (8.46 ± 4.50 to 7.89 ± 3.48), CCT, and OPP did not change significantly.

CONCLUSION

Choroidal BOM increased significantly during the initial 6 months of ADT, indicating higher microvascular resistance despite stable choroidal blood flow and unchanged large artery stiffness. This supports a "microcirculation-first" model. LSFG-derived BOM may serve as a biomarker for early detection and monitoring of microcirculatory dysfunction under systemic testosterone suppression.