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Diabetic Retinopathy

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...

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Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies

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Published on: October 22, 2014

Retinal microcirculation as a window to coronary artery disease.

Weronika Kowalczyk¹, Mikołaj Basza², Joanna Przybek-Skrzypecka¹

¹Department of Ophthalmology, Medical University of Warsaw, Poland; SPKSO Ophthalmic University Hospital in Warsaw, Poland.

European Journal of Internal Medicine

|June 17, 2026

Summary

Retinal imaging offers accessible biomarkers for coronary artery disease (CAD) risk, reflecting both epicardial atherosclerosis and microvascular dysfunction. This approach aids in differentiating CAD endotypes and improving patient risk assessment.

Keywords:

Coronary artery diseases Coronary microvascular dysfunction Retinal microcirculation

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Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography

Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography

Published on: March 26, 2020

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Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies

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Published on: October 22, 2014

Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography

Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography

Published on: March 26, 2020

Area of Science:

Ophthalmology and Cardiology
Biomarkers and Diagnostic Imaging
Vascular Biology

Background:

Coronary artery disease (CAD) encompasses epicardial stenosis and ischemia due to microvascular dysfunction.
Current coronary artery disease screening methods are invasive and costly.
Retinal imaging offers accessible biomarkers reflecting both epicardial atherosclerosis and coronary microvascular dysfunction.

Purpose of the Study:

To summarize the links between retinal measures and coronary anatomy, physiology, and clinical phenotypes.
To inform risk assessment strategies for coronary artery disease.
To explore the potential of retinal imaging in differentiating CAD endotypes.

Main Methods:

Narrative synthesis of studies.
Linking retinal structure and perfusion metrics (fundus, OCT/OCTA, FAZ, choroidal indices) with coronary angiography, functional ischemia indices (CFR, IMR, MFR), and clinical phenotypes (obstructive CAD, INOCA, slow coronary flow).

Main Results:

Retinal microvascular alterations (narrower arterioles, wider venules, lower arteriovenous ratio) predict CAD, MI, stroke, and mortality.
OCT angiography shows reduced vessel density and enlarged FAZ correlating with CAD severity and risk profiles.
Retinal findings in coronary microvascular dysfunction (CMD)/Ischemia with Non-Obstructive Coronary Arteries (INOCA) show generalized microvascular dysfunction, including sex-specific differences and links to slow coronary flow.

Conclusions:

Retinal imaging provides accessible biomarkers for systemic vascular alterations in CAD.
Retinal imaging may assist in risk stratification and endotype differentiation for CAD.
Clinical translation requires standardized studies, AI analytics, and integration with quantitative coronary physiology to overcome current limitations.