Free papers detail | 11th Asia Pacific Tele Ophthalmology Society Symposium

Title
Acute Effects of E-sports on Retinal-Choroidal Microcirculation and Photoreceptor Morphology: An AO-SLO and SS-OCTA Study

Authors
Pengcheng Li, Zhiqing Li

Presenting
Pengcheng Li

PURPOSE:
To multidimensionally evaluate acute changes in the structure, blood flow, and cone cell morphology of the macular retina and choroid after playing the mobile e-sports game Honor of Kings, utilizing Swept-Source Optical Coherence Tomography Angiography (SS-OCTA) and Adaptive Optics Scanning Laser Ophthalmoscope (AO-SLO).

METHODS:
This prospective observational study enrolled 35 healthy volunteers (66 eyes); 15 subjects (28 eyes) completed the AO-SLO examination. Subjects played a real-time game of Honor of Kings for 15 minutes in a standardized environment. SS-OCTA and AO-SLO images were acquired at baseline and within 5 minutes post-gaming. Key characteristics analyzed included macular inner nuclear layer (INL) thickness, choroidal thickness, choroidal vascular volume (CVV), and cone cell morphology.

METHODS:

This prospective observational study enrolled 35 healthy volunteers (66 eyes); 15 subjects (28 eyes) completed the AO-SLO examination. Subjects played a real-time game of Honor of Kings for 15 minutes in a standardized environment. SS-OCTA and AO-SLO images were acquired at baseline and within 5 minutes post-gaming. Key characteristics analyzed included macular inner nuclear layer (INL) thickness, choroidal thickness, choroidal vascular volume (CVV), and cone cell morphology.

RESULTS:
Following 15 minutes of high-intensity gaming, foveal (0–1 mm) CVV and choroidal thickness increased significantly. In the inner ring (1–3 mm), nasal choroidal thickness significantly increased. Conversely, average INL thickness (0–3 mm) exhibited acute post-game thinning. AO-SLO revealed that the proportion of regular hexagonal cone cells in the temporal region increased significantly, whereas the non-hexagonal cell population decreased. Across nine macular directions, the heptagonal cell proportion decreased overall.

RESULTS:

Following 15 minutes of high-intensity gaming, foveal (0–1 mm) CVV and choroidal thickness increased significantly. In the inner ring (1–3 mm), nasal choroidal thickness significantly increased. Conversely, average INL thickness (0–3 mm) exhibited acute post-game thinning. AO-SLO revealed that the proportion of regular hexagonal cone cells in the temporal region increased significantly, whereas the non-hexagonal cell population decreased. Across nine macular directions, the heptagonal cell proportion decreased overall.

CONCLUSIONS:
High-intensity mobile e-sports induce significant acute responses in the retinochoroidal neurovascular unit. This manifests as increased microvascular volume, compensatory choroidal thickening, INL contraction, and visual stimuli-driven regularized rearrangement of cone cells. These findings illuminate the dynamic regulatory mechanisms of fundus microcirculation under visual-cognitive tasks, offering potential objective imaging biomarkers for clinical quantitative evaluation of digital eye strain.

CONCLUSIONS:

High-intensity mobile e-sports induce significant acute responses in the retinochoroidal neurovascular unit. This manifests as increased microvascular volume, compensatory choroidal thickening, INL contraction, and visual stimuli-driven regularized rearrangement of cone cells. These findings illuminate the dynamic regulatory mechanisms of fundus microcirculation under visual-cognitive tasks, offering potential objective imaging biomarkers for clinical quantitative evaluation of digital eye strain.