Retinal and choroidal vascular changes in coronary heart disease: an optical coherence tomography angiography study.

J Wang,J Jiang,Y Zhang,J F Zhang,Z L Wang,Y W Qian

doi:10.1364/boe.10.001532

Abstract

To reveal the association between retinal microvasculature changes and coronary heart disease (CHD), we assessed the full retinal thicknesses of eight areas, the vessel density of four layers (consisting of nine areas) and the flow area in two layers with optical coherence tomography angiography (OCTA) in CHD patients and healthy controls. The mean vessel density of several layers was significantly lower in patients. The difference in choroid capillary flow (negative correlation) between the two groups was significant. Decreased vessel density and blood flow were associated with coronary artery and branch stenosis. The decreases in retinal vessel density, choroidal vessel density, and blood flow area are closely related to coronary artery and branch stenosis.

Highlights

Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally [1,2]
Our results showed that left main coronary artery (LMCA) and left circumflex (LCX)/right coronary artery (RCA) stenosis had a positive association with the vessel density of the outer layers
With optical coherence tomography angiography (OCTA), we detected that except for the superficial and deep fovea, vessel density in all retinal/choroidal layers and choroidal flow area decreased before any clinical fundus sign showed in CHD patients

Summary

Introduction

Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally [1,2]. The human retina (ten layers) is supplied by two vascular beds (retinal vessels and choriocapillaris). Retinal vessels supply the inner five layers and accommodate visual function. The outer five layers of the retina are almost avascular, receiving oxygen and nutrients from the choroidal circulation. Because fundus vessels are approximately the same magnitude as the coronary microvasculature, they can serve as a representative of processes occurring in subclinical coronary stenosis [7]. Both retinal and choroidal vessels are supplied by the ophthalmic artery (OA), one of the terminal branches of the coronary artery. The retina and choroid may be affected by coronary artery stenosis. The retinal microvasculature has been proposed as an measured surrogate for the coronary circulation in several pieces of literature even though there is still conflicting evidence as to the strength of evidence [7]

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