Association between retinal microcirculation and cardiac function: A cross-sectional study using OCTA

To investigate the association between retinal microcirculation and cardiac function using optical coherence tomography angiography (OCTA).

In this cross-sectional study, 78 participants who underwent both OCTA and transthoracic echocardiography were included. OCTA was used to quantify vessel density (VD) and perfusion density (PD) in the optic disc region. Cardiac function parameters, including left ventricular ejection fraction (EF), mitral valve E wave (MV-E), and A wave (MV-A), were obtained via echocardiography. Correlation analyses and univariate and multivariable linear regression models were applied to evaluate associations between retinal microvascular metrics and cardiac function.

Retinal VD and PD in all regions showed significant positive correlations with EF, indicating that better cardiac systolic function is associated with higher microvascular density and perfusion. MV-E, reflecting early diastolic function, was also positively correlated with inner and whole retinal VD and PD, whereas MV-A showed no significant association. Multivariable regression confirmed that EF and MV-E were independent positive determinants of whole VD and PD, while cerebrovascular disease was independently associated with reduced retinal microcirculation. Age demonstrated a negative association with VD.

Retinal microcirculation is closely linked to both systolic and diastolic cardiac function. OCTA-derived parameters, particularly VD and PD, may provide a non-invasive and quantitative approach for assessing systemic cardiovascular status and hold potential may serve as potential indicators of cardiovascular dysfunction.