Abstract
Purpose :
Coronary heart disease (CHD) is the leading cause of morbidity and mortality that affects millions of people worldwide. To-date, risk stratification tools for CHD are complex, relying on cumbersome and time-consuming diagnostic techniques with modest results. Therefore, many patients need to undergo invasive coronary angiography for the definite diagnosis of CHD to be made. The aim of this study is to evaluate the use of retinal imaging of microvascular architecture and perfusion for the identification of novel biomarkers to accurately predict the development and progression of cardiovascular disease.
Methods :
In this prospective, cross-sectional pilot study we included all patients presenting to a tertiary referral center for coronary angiography (CA) due to suspected CHD. All patients underwent optical coherence tomography angiography of both eyes to measure vessel density (VD) and fractal dimension (FD) of the individual capillary plexuses in 6×6-mm macular and optic nerve head (ONH) volume scans. Mixed models were calculated for each dependent variable (Stenosis, sex, age, Hba1c, and creatinine) for both eyes.
Results :
In the cohort of 558 patients, stenosis of epicardial vessels were statistically significantly associated with macular VD loss (p=0,006) and lower FD (p=0,001) in the inner ring (1-3mm). Association in central and outer ring (1mm, 6mm) were not significant. There were no statistically significant associations of stenosis with 6x6mm ONH VD or FD.
Conclusions :
In patients with CVD, we observed microvascular changes in retinal OCT-As. This high-resolution quantitative microvascular phenotyping in the retina may provide valuable subclinical indicators for coronary artery impairment.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.