July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Retinal imaging to evaluate choroidal thickness in patients with ischaemic heart disease in Northern India
Author Affiliations & Notes
  • Akanksha Prasad
    Ophthalmology, RML and PGIMER Institute , New Delhi, India
  • Praveen Malik
    Ophthalmology, RML and PGIMER Institute , New Delhi, India
  • Neeraj Pandit
    Cardiology, RML and PGIMER Institute, New Delhi, India
  • Footnotes
    Commercial Relationships   Akanksha Prasad, None; Praveen Malik, None; Neeraj Pandit, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1895. doi:
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      Akanksha Prasad, Praveen Malik, Neeraj Pandit; Retinal imaging to evaluate choroidal thickness in patients with ischaemic heart disease in Northern India. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1895.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate choroidal thickness (CT) and other OCT biomarkers in patients with ischaemic heart disease (IHD) compared to healthy controls.

Methods : A comprehensive ophthalmic evaluation was performed in all subjects.
Cross sectional study was done in a large multispeciality hospital serving Northern India. Forty patients with established IHD, defined as history of >50% obstruction in at least one coronary artery, acute coronary event or revascularization procedure were recruited from the Cardiology clinic after Institutional review board approval.Thirty-four age-matched controls had no evidence of IHD or diabetes. Patients with advanced cataract, retinal dystrophy were excluded.
Structural analysis of the retina was performed using enhanced depth imaging with Cirrus HD-OCT (Carl Zeiss Meditec Inc, Dublin, CA).
The Cirrus OCT macular cube 512 x 128 protocol was used to provide macular volume measure and retinal thickness values for nine areas that correspond to the Early Treatment Diabetic Retinopathy Study grid.
Choroidal thickness was measured using an inbuilt tool at four cardinal areas - superior, inferior, nasal, and temporal to the fovea and subfoveal location.
Statistical analysis was performed on SPSS 22.0 (IBM Corp)

Results : Data was examined for patients with established IHD and their age matched controls.
CT was significantly lower in patients with IHD compared to controls at the subfoveal location (235 vs. 325 μm, P <0.005) and at all 4 cardinal macular locations. The mean difference in CT between the two groups was greatest in the location inferior to the fovea.
CT was significantly lower temporally (P <0.005) and nasally (P<0.001) than subfoveally in the IHD group and co-related with the observation in control group.
On multivariate analysis, IHD was negatively associated with subfoveal CT (P < 0.005) after controlling for risk factors.

Conclusions : Our study found that patients with IHD have a thinner macular choroid than controls. Decreased CT might predispose patients with IHD to high-risk phenotypes of age-related macular degeneration. Multiple prospective population based studies have demonstrated a significant association between coronary disease and age related macular degeneration, more than doubling the risk of acute coronary events.
Thus, retinal imaging can serve as a disease marker in IHD and provide information on susceptibility to diseases of outer retina and RPE.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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