THE DEEP CAPILLARY PLEXUS OF THE EYE MIRRORS THE HEART IN TERMS OF MICROVASCULAR DYSFUNCTION: An OCTA Study

This study investigated retinal microvascular alterations using optical coherence tomography angiography in patients with coronary microvascular dysfunction (CMD), including slow coronary flow and ectatic coronary arteries.

One hundred and seventy-four eyes from 92 patients with CMD and 82 healthy controls were included in the study. Routine ophthalmic examination was performed, and optical coherence tomography angiography was used to assess both the macula and optic disc. Vascular density of vessels in the superficial capillary plexus and deep capillary plexus of the macula, radial peripapillary capillaries blood supply regions, and the size of the foveal avascular zone were detected.

Univariate regression revealed significant differences in the superficial capillary plexus, deep capillary plexus, and foveal avascular zone between patients with CMD and healthy controls (all p < 0.05). Multivariate analysis identified the deep capillary plexus as the sole independent predictor of CMD (Odds Ratio (OR) [Confidence Interval (CI)]; 7.54 [2.69-21.12]).

These findings align with existing literature demonstrating retinal-cardiovascular correlations and highlight the deep capillary plexus as a potential non-invasive biomarker for CMD, particularly in male patients. The results support optical coherence tomography angiographies' utility in cardiovascular risk stratification, with sex-specific patterns warranting further investigation in larger cohorts.