RETINAL WALL TO LUMEN RATIO IN PATIENTS WITH ANGINA AND NO CORONARY ARTERY DISEASE. AN EYE TO THE HEART

Abstract

Objective: The vasculature of the eye and of the heart share several common characteristics. Therefore, the easily accessible vessels of the eye may be considered, to some extent, a “window” to the heart. Aim of this study was to evaluate retinal arterioles morphological changes in patients with angina and nonobstructive coronary artery disease. Design and method: In 19 patients (M:W 11:8, mean age 71 + 6 years) with microvascular angina (MA), confirmed by normal coronary angiography and SPECT stress hypoperfusion and in 18 controls (C) (M:W 10:8, mean age 69 ± 6 years) with normal SPECT response, direct measurement of wall to lumen of retinal arterioles (W/L) using an adaptive optics (AO) imaging system (Imagine Eyes, Orsay, France) was performed. All subjects also underwent BP measurement with an automated oscillometric device (Omron HEM 9000Ai, mean of 3 measurements). Results: No differences in demographic and hemodynamic characteristics were observed between MA patients and C, except for BMI (BMI 30 ± 4.2 vs 24 ± 4 kg/m2, in MA and C respectively, p = 0.001). Retinal arterioles wall thickness (11.75 ± 1.45 vs 13.9 ± 1.53 microm), W/L ratio (0.29 ± 0.05 vs 0.25 ± 0.03 in MA and C respectively, p = 0.008) and wall cross sectional area (WCSA) (4876 ± 976 vs 4004 ± 872 microm2, respectively in MA and C, p = 0.012) were higher in MA patients as compared with C. Differences were confirmed after adjustment for BMI. Conclusions: Our findings suggest that in patients with angina and normal coronary arteries retinal structural changes may be observed.