Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study

Area of Science:

• Cardiovascular Research
• Ophthalmology
• Vascular Biology

Background:

• Ischemia with no obstructive coronary artery disease (INOCA) is frequently associated with coronary microvascular dysfunction (CMD), suggesting broader systemic vascular impairment.
• The relationship between retinal microvasculature, which reflects cardiovascular risk factors, and CMD is not well understood.

Purpose of the Study:

• To investigate and compare retinal microvascular density in women diagnosed with INOCA, differentiating between those with and without CMD.
• To explore the potential of non-invasive retinal imaging as a biomarker for coronary microvascular function.

Main Methods:

• A cross-sectional study involving 18 women with INOCA who underwent coronary function testing.
• Participants were categorized into CMD (coronary flow reserve <2.5) and non-CMD groups.
• Retinal optical coherence tomography angiography was utilized for noninvasive assessment of retinal microvasculature.

Main Results:

• The CMD group (N=11) demonstrated significantly lower retinal vessel density (20.9 vs 21.6, p=0.006) and inner perfusion density (38.5 vs 41.2, p=0.006) compared to the non-CMD group (N=7).
• No significant differences were observed in the foveal avascular zone (FAZ) area, perimeter, or circularity between the groups.
• Demographic and clinical characteristics, including age and cardiovascular risk factors, were well-balanced between the CMD and non-CMD groups.

Conclusions:

• Women with INOCA and CMD exhibit reduced retinal microvascular and perfusion densities compared to those without CMD.
• Non-invasive retinal imaging presents a feasible and affordable method that may correlate with coronary microvascular function in INOCA patients.
• Further research with larger cohorts, including male participants, is warranted to validate these findings.