Ophthalmology and therapy · 2026
Retinal Microvascular Morphometry in Recreational Athletes Using Anabolic-Androgenic Steroids: A Cross-Sectional Study.
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El-Cheikh Mahmoud Anas A, Thinggaard Benjamin S, Hjortebjerg Rikke, Buhl Laust F, Grauslund Jakob, Christensen Louise L, Glintborg Dorte, Andersen Marianne S, Lindholt Jes S, Diederichsen Axel, Thevis Mario, Kistorp Caroline, Frystyk Jan, Pedersen Frederik N
Аннотация
INTRODUCTION: Illicit use of anabolic-androgenic steroids (AAS) is common among recreational athletes and is associated with cardiovascular complications and premature death. However, effects on the microvasculature have not been quantified. The retina provides non-invasive access to the systemic microvasculature, and retinal vessel morphometry has been associated with incident cardiovascular events.
METHODS: We conducted a cross-sectional study of 151 recreational athletes from the Fitness Doping in Denmark study: 74 active AAS users, 26 former users who had ceased AAS use at least 3 months before enrollment, and 51 age- and sex-matched controls with no lifetime AAS exposure. Disc-centered fundus photographs were analyzed using semiautomated software to obtain the arteriovenous ratio (AVR), central retinal arteriolar and venular equivalents (CRAE/CRVE), arteriolar and venular fractal dimensions, and arteriolar and venular tortuosity. Associations of active AAS use and cumulative lifetime AAS exposure with retinal vessel morphometry were assessed through multivariable linear regression models adjusted for age, sex, and body fat percentage.
RESULTS: Active users had a lower arteriolar fractal dimension than both controls (1.12 vs. 1.16, P < 0.05) and former users (1.12 vs. 1.18, P < 0.05), and a lower AVR than controls (0.67 vs. 0.70, P < 0.05) in multivariable models. Former users did not differ from controls on any retinal variable. Cumulative lifetime AAS exposure was not independently associated with any outcome.
CONCLUSION: Active AAS use was associated with lower arteriolar fractal dimension and lower AVR after adjustment. These differences were absent in former users and unrelated to cumulative exposure duration. The cross-sectional design precludes determining the prognostic significance of these differences.
TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT05178537.
METHODS: We conducted a cross-sectional study of 151 recreational athletes from the Fitness Doping in Denmark study: 74 active AAS users, 26 former users who had ceased AAS use at least 3 months before enrollment, and 51 age- and sex-matched controls with no lifetime AAS exposure. Disc-centered fundus photographs were analyzed using semiautomated software to obtain the arteriovenous ratio (AVR), central retinal arteriolar and venular equivalents (CRAE/CRVE), arteriolar and venular fractal dimensions, and arteriolar and venular tortuosity. Associations of active AAS use and cumulative lifetime AAS exposure with retinal vessel morphometry were assessed through multivariable linear regression models adjusted for age, sex, and body fat percentage.
RESULTS: Active users had a lower arteriolar fractal dimension than both controls (1.12 vs. 1.16, P < 0.05) and former users (1.12 vs. 1.18, P < 0.05), and a lower AVR than controls (0.67 vs. 0.70, P < 0.05) in multivariable models. Former users did not differ from controls on any retinal variable. Cumulative lifetime AAS exposure was not independently associated with any outcome.
CONCLUSION: Active AAS use was associated with lower arteriolar fractal dimension and lower AVR after adjustment. These differences were absent in former users and unrelated to cumulative exposure duration. The cross-sectional design precludes determining the prognostic significance of these differences.
TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT05178537.