Subclinical Coronary Atherosclerosis and Retinal Optical Coherence Tomography Angiography

Area of Science:

• Ophthalmology
• Cardiology
• Medical Imaging

Background:

• Systemic disease burden is reflected in retinal microvasculature.
• The link between optical coherence tomography angiography (OCTA) parameters and coronary atherosclerosis is not well-established.

Purpose of the Study:

• To assess the association between reduced retinal vascular density and subclinical coronary atherosclerosis in asymptomatic individuals with elevated cardiovascular risk.

Main Methods:

• Cross-sectional cohort study of 1286 asymptomatic individuals undergoing coronary computed tomography angiography (CTA) and OCTA.
• Analysis of OCTA parameters, including superficial and deep parafoveal vascular density (PFVD), and coronary CTA parameters like coronary artery calcium score (CACS) and obstructive coronary artery disease (CAD).

Main Results:

• Reduced superficial and deep PFVD were significantly associated with increased CACS, plaque burden, and stenosis severity.
• Lower superficial capillary plexus (SCP) PFVD was linked to higher odds of obstructive and severe CAD.
• Incorporating PFVD into risk models improved the area under the curve (AUC) for identifying severe and obstructive CAD.

Conclusions:

• Reduced retinal PFVD is independently associated with subclinical coronary atherosclerosis in individuals with elevated vascular risk.
• Decreased PFVD may indicate a greater coronary atherosclerotic burden and aid in identifying individuals for further cardiac evaluation.