Related Experiment Video
Updated: Jun 17, 2026
10:11
Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies
Published on: October 22, 2014
Microvascular retinal changes in patients presenting with acute coronary syndromes
S Kralev1, E Zimmerer, P Buchholz
11(st) Medical Department, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. stefan.kralev@umm.de
Microvascular Research
|January 8, 2010
Summary
Patients with acute coronary syndromes (ACS) show more retinal microaneurysms and dot bleedings compared to stable coronary artery disease (CAD). Retinal examination may aid in assessing cardiovascular risk profiles.
Area of Science:
- Ophthalmology
- Cardiology
- Vascular Medicine
Background:
- Retinal microvascular changes are known predictors of cardiovascular outcomes.
- The specific retinal manifestations in patients with acute coronary syndromes (ACS) versus stable coronary artery disease (CAD) require further elucidation.
Purpose of the Study:
- To investigate and compare the prevalence of specific retinal changes in patients with ACS and stable CAD.
- To assess the potential role of retinal fundus examination in identifying patients at higher cardiovascular risk.
Main Methods:
- Retinal fundus photography was performed within 48 hours post-coronary angiography in 43 ACS patients and 19 stable CAD patients.
- Assessment included retinopathy, arteriolar narrowing, and arterio-venous ratio (AVR).
- Clinical and laboratory cardiovascular risk factors were systematically recorded.
Main Results:
- Patients with ACS exhibited a significantly higher incidence of retinal microaneurysms and dot bleedings compared to stable CAD patients (40% vs. 5%, p=0.006).
- This association remained significant after multivariate analysis (OR 20.5, p=0.019).
- While arteriovenous nicking was more frequent in CAD patients, this finding lacked statistical significance post-multivariate analysis.
Conclusions:
- Acute coronary syndrome patients more frequently present with specific retinal findings like dot bleedings and microaneurysms.
- Retinal fundus examination shows promise as a tool to augment cardiovascular risk stratification.
- These findings suggest enhanced patient monitoring and care for individuals identified through retinal assessment.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
01:30Acute Coronary Syndrome I: Introduction
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
01:27Diabetic Retinopathy
DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
01:30Coronary Artery Disease III: Clinical Manifestations
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...