Chapter 15 - Retinal biomarkers and cardiovascular disease: A clinical perspective

Abstract

Cardiovascular disease (CVD), comprising coronary heart disease and stroke, remains a major cause of morbidity and mortality globally. The retinal vasculature is a unique biological model to study microvascular pathology associated with CVD. Retinal vascular imaging technologies have been developed to allow objective and precise assessment of retinal vascular changes which mirror pre-clinical structural changes in the systemic peripheral, cerebral and coronary microcirculation. Current research shows that retinal vascular changes are associated with CVD risk factors, subclinical CVD measures and predict future CVD events. Importantly, recent studies also demonstrated that the addition of retinal vasculature assessment significantly improves measures of calibration, discrimination, and risk reclassification for CVD, compared with models on established risk factors. This chapter aims to review our current understanding and associations between retinal vascular changes and CVD, and chart future directions on incorporating retinal vascular biomarkers into CVD risk assessment.