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Updated: Oct 17, 2026
Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
Retinal layer thickness as a potential marker for future cardiovascular events - a UK Biobank cohort study using
Martin Hänsel1, Julian Deseoe1, Lisa Herzog1
1Department of Neurology and Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland.
Aims:
Cardiovascular disease (CVD) is the leading cause of death worldwide. For CVD prevention, effective screening is needed to identify high-risk individuals. Optical coherence tomography (OCT) provides a noninvasive, low-cost "quick look" into the brain and has recently shown thinning of certain retinal layers in patients with previous CVD. We explored if OCT-derived retinal layer thicknesses could predict future major adverse cardiovascular events (MACE: stroke/myocardial infarction/cardiovascular death).
Methods:
In this retrospective cohort study, data of 51,293 participants from the UK Biobank were analyzed. We used cause-specific hazard models to evaluate the association of retinal nerve fiber layer thickness (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness with incident MACE, adjusting models for cardiovascular risk factors (CVRF) and performed subanalyses for association with incident stroke and myocardial infarction.
Results:
Median follow-up time was 14.7 years. Both RNFL thickness (aHR 0.92, 95% CI 0.89-0.96, p < 0.001) and GCIPL thickness (aHR 0.96, 95% CI 0.92-1.00, p = 0.04) were statistically associated with incident MACE in cause-specific hazard models adjusted for CVRF. Interestingly, RNFL thickness was more strongly associated with incident myocardial infarction (aHR 0.94, 95% CI 0.88-0.99, p = 0.02) while GCIPL was more strongly associated with incident stroke (aHR 0.90, 95% CI 0.83-0.96, p = 0.003).
Conclusion:
RNFL and GCIPL thicknesses are associated with future MACE, even after adjusting for CVRF. OCT-measured retinal layer thickness could contribute to the assessment of cardiovascular risk.
