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Retinal Ischemic Perivascular Lesions in Pulmonary Hypertension: Retinal Biomarkers Informing Systemic Microvascular
Jay B Bisen1, Hayden Sikora1, Richa Shah1
1Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Translational Vision Science & Technology
|June 23, 2026
Summary
Retinal ischemic perivascular lesions (RIPLs) are more common in patients with pulmonary hypertension (PH) and pre-PH than in controls. RIPL counts vary among PH subtypes, suggesting a link to systemic vascular disease.
Area of Science:
- Ophthalmology and Cardiovascular Research
- Investigating microvascular changes in retinal and pulmonary vasculature
- Utilizing optical coherence tomography (OCT) for retinal lesion detection
Background:
- Retinal ischemic perivascular lesions (RIPLs) are indicators of subclinical retinal infarcts and are associated with cardiovascular diseases like hypertension and type 2 diabetes.
- Pulmonary hypertension (PH) is a complex condition with varied causes, impacting the pulmonary vasculature.
- Understanding markers for early detection and stratification in PH is crucial for patient management.
Purpose of the Study:
- To investigate the association between RIPLs and pulmonary hypertension (PH).
- To compare RIPL counts between PH patients and healthy controls.
- To explore RIPL differences across various PH subtypes.
Main Methods:
- A retrospective, cross-sectional study involving 129 participants (65 controls, 18 pre-PH, 46 PH).
- Macular OCT scans were used to assess RIPLs.
- Statistical analyses compared RIPL counts and prevalence between groups, adjusting for potential confounders.
Main Results:
- Patients with pre-PH (94%) and PH (70%) exhibited higher RIPL prevalence than controls (48%).
- RIPL counts were elevated in pre-PH (5.78) and PH (3.93) groups compared to controls (2.05).
- PH related to lung disease showed lower RIPL counts than other PH subtypes.
Conclusions:
- Elevated RIPL counts in patients with pre-PH and PH suggest a link to systemic vascular dysfunction.
- RIPLs may serve as potential biomarkers for early detection and risk stratification in PH.
- Differences in RIPLs among PH subtypes highlight the complex interplay of vascular health.
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