Retinal microvascular density on Optical Coherence Tomography Angiography and Osteoprotegerin serum levels in acute coronary syndrome patients

Abstract

Optical Coherence Tomography - Angiography (OCT-A) is a quick and noninvasive exam performed to obtain a quantitative analysis of retinal microvascularisation. It is still unknown if this analysis reflects the systemic vascular status, and thus could be used as a screening tool for cardiovascular diseases. Osteoprotegerin is an atherosclerosis biomarker involved in the development of ischemic cardiovascular diseases. The aim of this study was to seek for a relation between Osteoprotegerin serum and retinal microvascularisation density through OCT-A in patients with a high cardiovascular risk profile. Patients hospitalized for an acute coronary syndrome in our University Hospital were prospectively included, and had a blood sample analysis and OCT-A imaging within 48 hours of hospitalisation. Angioplex v10 software was used to analyze retinal microvascularisation density in the Superficial Capillary Plexus (SCP). A Pearson linear correlation was performed between SCP density measured with OCT-A and serum levels of Osteoprotegerin. We also recorded demographic data, cardiovascular risks, and patients’ treatments. Overall, 54 patients were included in our study with a mean age of 59 ± 12 year. Among these patients, 80% were male ( n = 43), 46% had previous hypertension ( n = 25), 39% were obese ( n = 21), 39% had a hypercholesterolemia, and 39% were smokers. A statistically significant correlation was found between serum levels of Osteoprotegerin and retinal microvascularisation density measured by OCT-A ( r = −0.355, P = 0.008). After adjustment on age, high Osteoprotegerin levels remained almost significantly associated with a low retinal microvascularisation density ( P = 0.052). Our preliminary results suggest a link between retinal microvascularisation measured by OCT-A and systemic vascular disease, estimated through high Osteoprotegerin serum levels.