Related Experiment Video
Updated: Sep 16, 2025
Evaluation of Capillary and Other Vessel Contribution to Macular Perfusion Density Measured with Optical Coherence Tomography Angiography
Published on: February 18, 2022
Superficial Retinal Intercapillary Oxygen Diffusion and Perfusion Deficit Alterations in Patients With Coronary
Natasa Jeremic1,2, Meltem Esengönül1,3, Azin Zarghami2
1Laboratory for Ophthalmic Image Analysis (OPTIMA), Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Insights
Geometric perfusion deficits (GPDs) detected via retinal imaging show significant association with coronary artery disease (CAD). These GPD metrics, particularly in the parafoveal region, offer a promising non-invasive method for CAD detection and severity assessment.
Area of Science:
- Ophthalmology
- Cardiology
- Medical Imaging
Background:
- Coronary artery disease (CAD) detection can be improved with non-invasive methods.
- Retinal imaging offers a potential avenue for early CAD detection.
Purpose of the Study:
- To investigate the association between geometric perfusion deficits (GPDs) in the retina and coronary artery disease (CAD).
- To analyze the topographical patterns of GPDs in relation to CAD severity.
Main Methods:
- Optical coherence tomography angiography (OCTA) images of the superficial capillary plexus were analyzed in patients with and without CAD.
- Metrics such as GPD density, count, ischemic extent (IE), and top 10 GPD areas (MT10) were extracted.
- Multivariate mixed-effects models were used to assess the association with the Gensini score (GS) for CAD severity.
Main Results:
- All analyzed GPD metrics (density, IE, MT10, count) showed significant associations with CAD severity (GS).
- The parafoveal area exhibited the most significant and consistent changes in GPDs.
- Significant differences in GPDs were observed between non-CAD and moderate/severe CAD groups, with GPD metrics demonstrating higher predictive ability than conventional OCTA metrics.
Conclusions:
- Four GPD metrics are significantly associated with CAD, with parafoveal GPDs being the most indicative.
- Retinal GPD analysis can differentiate between patients with and without CAD.
- GPDs represent a novel, non-invasive biomarker for CAD detection and assessment.
Purpose:
Retinal imaging may offer a non-invasive method to detect coronary artery disease (CAD). Geometric perfusion deficits (GPDs), defined as intercapillary areas beyond 30 µm from the nearest vessel, were analyzed for their CAD association and topographical patterns.
Methods:
Patients undergoing coronary angiography and healthy controls (mean ages: non-CAD, 58 ± 9 years; CAD, 61 ± 9 years) were assessed. Fovea-centered 6 × 6-mm optical coherence tomography angiography (OCTA) images were acquired, and the superficial capillary plexus was analyzed. GPD density, count, ischemic extent (IE), and top 10 GPD areas (MT10) were extracted. The Gensini score (GS) quantified CAD severity. Multivariate mixed-effects models were calculated for statistical analysis.
Results:
This study analyzed 237 patients (382 eyes), 141 (225 eyes) with CAD. Significant associations with the GS were found across all metrics after adjustments (density coefficient = 0.050, P = 0.001; IE coefficient = 0.002, P = 0.005; MT10 coefficient = 0.066, P = 0.005; count coefficient = 0.015, P = 0.003). The most profound changes were observed in the parafovea. Significant group differences were found between the non-CAD and moderate CAD groups, as well as between the non-CAD and severe CAD groups in the total image and the parafovea, temporal, and nasal outer segments. Moderate and severe CAD did not display significant differences. GPD metrics showed higher predictive abilities than conventional OCTA metrics.
Conclusions:
Four GPD metrics were significantly associated with CAD, with the parafoveal area showing the highest significance and consistency. GPDs differed significantly between CAD and non-CAD patients.
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