Early diagnosis of coronary heart disease based on retinal microvascular parameters of OCTA
Shijia Zhou1,2, Qifeng Yan1, Jiaqi Guo1
1Laboratory of Advanced Theranostic Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China.
Insights
Optical coherence tomography angiography (OCTA) reveals reduced retinal microvascular complexity in patients with coronary artery disease (CAD). These OCTA biomarkers show potential for early CAD diagnosis and risk stratification.
Area of Science:
- Ophthalmology
- Cardiology
- Medical Imaging
Background:
- Coronary artery disease (CAD) is a major cause of global cardiovascular mortality.
- Early diagnosis of CAD is crucial for effective prevention and treatment strategies.
- Retinal microvasculature changes may reflect systemic vascular health, offering diagnostic potential.
Purpose of the Study:
- To investigate the association between OCTA-derived retinal microvascular parameters and CAD.
- To evaluate OCTA as a non-invasive tool for early CAD detection.
Main Methods:
- Analysis of OCTA images from 747 participants (332 with CAD, 415 controls).
- Extraction and quantification of retinal microvascular parameters including vessel density, length density, tortuosity, and bifurcation complexity.
- Statistical comparison of parameters between CAD patients and controls.
Main Results:
- Patients with CAD showed significantly lower retinal vessel density, vessel length density, tortuosity, and vascular bifurcation complexity compared to controls.
- These differences were particularly pronounced in the left eye, suggesting lateral asymmetry.
- OCTA-derived biomarkers were associated with CAD status.
Conclusions:
- OCTA can detect significant alterations in retinal microvasculature associated with CAD.
- Retinal microvascular biomarkers from OCTA show promise for the early diagnosis and risk assessment of CAD.
- OCTA-based retinal biomarkers may become a valuable tool in clinical practice for cardiovascular health assessment.
Abstract:
Coronary artery disease (CAD) is a leading cause of cardiovascular mortality worldwide, and its early diagnosis is essential for prevention and treatment. Emerging evidence from ocular imaging suggests that structural and functional alterations in the retinal vasculature may mirror systemic vascular changes, offering a promising avenue for the early identification of cardiovascular conditions such as CAD. Among these techniques, OCTA stands out as a non-invasive, high-resolution modality capable of capturing detailed microvascular architecture and quantifying retinal blood flow dynamics. In this study, we analyzed OCTA images from 747 participants including 332 patients with CAD and 415 controls to extract retinal microvascular parameters and evaluate their associations with disease status. The results revealed that patients with CAD exhibited significantly lower retinal vessel density, vessel length density, tortuosity, and vascular bifurcation complexity on OCTA compared to controls, particularly in the left eye. This suggests possible lateral asymmetry in microvascular responses associated with CAD. Overall, we highlight the potential of OCTA-derived retinal biomarkers in supporting the early diagnosis of CAD, providing a standard tool for future clinical services and research. Biomarkers in retinal OCTA images can provide useful information for clinical decision making and diagnosis of CAD.
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