Abstract
Background: Retinal microvascular evaluation could serve as a marker for cardiovascular disease risk. OCTA is a noninvasive method to quantitatively assess the retinal microvasculature. Coronary flow reserve (CFR), an integrated measure of focal, diffuse, and small-vessel coronary artery disease, identifies patients at risk for cardiac death. We aimed to identify associations between OCTA findings and CFR in patients undergoing cardiac positron emission tomography (PET) testing. Methods: Subjects (n=60) underwent a stress myocardial perfusion PET scan to quantify CFR and OCTA of both eyes on same day. CFR is the ratio of myocardial blood flow at peak stress compared to rest and adjusted for baseline cardiac work. OCTA scans were analyzed using a custom-built software to quantify foveal avascular zone (FAZ) geometry and vessel density metrics in the retina, reflecting retinal microvasculature. We used Spearman to correlate markers of retinal microvasculature with CFR. Results: Demographics of enrolled subjects are shown in Table I. Baseline cardiac risk factors were common and 22 (37%) subjects had an abnormal stress test. Retinal perfusion as indicated by the vessel index (ρ=0.35, p=0.006) and vessel diameter index (ρ=0.27, p=0.039) in the superficial 6x6 mm slabs were positively correlated with CFR. There was a trend towards negative association between FAZ area in the retina slab and CFR (ρ= -0.17, p=0.1). Conclusions: CFR was correlated with retinal perfusion indices based on OCTA, suggesting a relationship between coronary and retinal vascular health. These data provide potential insight into systemic vascular health and could provide an additional tool to assess cardiac risk.
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