Retinal microvascular perfusion reflects cardiovascular status in diabetic patients

Yin Yonghui et al.Subclinical coronary atherosclerosis and retinal optical coherence tomography angiography: an observational cohort study.Published in: American Society of Retina Specialists Annual Meeting; July 13-16, 2022; New York.
Yin Yonghui et al.Subclinical coronary atherosclerosis and retinal optical coherence tomography angiography: an observational cohort study.Published in: American Society of Retina Specialists Annual Meeting; July 13-16, 2022; New York.
NEW YORK – In patients with type 2 diabetes, decreased parafoveal vessel density may indicate coronary insufficiency and the potential for cardiac events, according to a speaker.
“Coronary artery disease (CAD) is the leading cause of death in diabetic patients, and 25% of diabetic retinopathy patients have overt stenotic CAD. We hypothesized that retinal microvascular perfusion may reflect cardiovascular status,” said Young Hee Yoon, MD, a retina specialist in the United States said at the association’s annual meeting.
In one study, the association between OCT angiography (OCTA), microvascular parameters, and risk of subclinical CAD was assessed in 654 patients with type 2 diabetes receiving eye care.They underwent a detailed ophthalmologic examination, including OCTA (AngioVue, Optovue) and coronary risk assessment to identify arteriosclerosis by coronary computed tomography angiography.The mean age of the patients was 65 years, more than 40% had a history of smoking, and two-thirds had hypertension.The mean parafoveal vessel density (VD) was 43.7 for the superficial capillary plexus (SCP) and 48.1 for the deep capillary plexus (DCP).
“Approximately 35% had obstructive CAD and 15% had high-risk CAD. The mean coronary artery calcium score was 241, and 34% of patients scored over 100. Statistical analysis showed a significant association with SCP and DCP parafoveal VD,” Yoon Say.
Patients were then divided into four quartiles based on parafoveal VD, ranging from high VD (quartile one) to low VD (quartile four).Among baseline characteristics, lower VD quartiles were associated with older age and later stages of diabetic retinopathy.
“The risk of obstructive CAD and high-risk CAD was significantly higher in the low-vessel-density SCP and DCP quartiles,” Yoon said.”The higher risk remained significant even after adjusting for age, sex and [cardiovascular] risk factors, including age, sex, hypertension, smoking history and hyperlipidemia.”
Therefore, coronary screening may help detect subclinical CAD in diabetic patients with low foveal VD, she said.


Post time: Jul-28-2022