Retinal Changes Linked to PCOS
Meta-analysis of OCT and OCT angiography studies found thicker retinal nerve fiber layers and slightly thinner central macula in patients with polycystic ovary syndrome.
By
Julie Greenbaum
March 16, 2026
Clinical Scorecard: Retinal Changes Linked to PCOS
At a Glance
Category Detail
Condition Polycystic Ovary Syndrome (PCOS) Key Mechanisms Retinal structural differences including thicker retinal nerve fiber layers and thinner central macula. Target Population Women diagnosed with PCOS, primarily aged 22 to 36 years. Care Setting Ophthalmic imaging studies using OCT and OCTA.
Key Highlights
Thicker average peripapillary retinal nerve fiber layer (RNFL) in PCOS patients by about 4 µm. Statistically significant reduction in central macular thickness in PCOS patients by about 3 µm. Thicker choroidal measurements in PCOS patients with an average increase of about 58 µm. No consistent differences in retinal microvascular density between PCOS patients and controls. Study quality rated as good, with moderate certainty of evidence for RNFL and macular thickness. Guideline-Based Recommendations
Diagnosis
Diagnosis of PCOS primarily using Rotterdam criteria. Management
Consider monitoring retinal changes in patients with PCOS. Monitoring & Follow-up
Regular ophthalmic evaluations using OCT and OCTA. Risks
Potential for structural retinal changes despite unchanged microvascular density. Patient & Prescribing Data
Women with PCOS, including newly diagnosed and those with longer-standing diagnoses.
Structural remodeling may occur in the absence of measurable microvascular density changes.
Clinical Best Practices
Utilize standardized OCT imaging protocols to minimize variability. Assess body mass index and disease duration consistently across studies. References
