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

Wang, J.; Jiang, Jing; Zhang, Y.; Qian, Yu; Zhang, J. F.; Wang, Zhouqian

doi:10.1364/boe.10.001532

Cited by 122 publications

(110 citation statements)

References 39 publications

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“…However, the optic disc VD was shown to reduce only in patients with first diagnosis of systemic hypertension but not in patients already treated for systemic hypertension 49 . Wang et al 48 also reported decreased retinal and choroidal VD in the macular region in patients with coronary heart disease. In our study, only subjects with treated hypertension and mild cardiovascular diseases rather than coronary artery disease were enrolled.…”

Section: Discussionmentioning

confidence: 92%

“…This area may be too small to adequately sample retinal vascular changes in glaucoma. Fifth, reduced macular VD and increased foveal avascular zone in patients with hypertension have been reported 47,48 . However, the optic disc VD was shown to reduce only in patients with first diagnosis of systemic hypertension but not in patients already treated for systemic hypertension 49 .…”

Section: Discussionmentioning

confidence: 97%

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Optic Disc and Macular Vessel Density Measured by Optical Coherence Tomography Angiography in Open-Angle and Angle-Closure Glaucoma

Hou

Kuang

et al. 2020

Sci Rep

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there is distinct pathogenesis between primary open-angle glaucoma (poAG) and primary angleclosure glaucoma (pAcG). Although elevated intraocular pressure (iop) is the major risk factor for glaucoma, non-IOP risk factors such as vascular abnormalities and lower systolic/diastolic perfusion pressure may play a role in the pathogenic process. this study aimed to compare the vessel density (VD) in the optic disc and macula using optical coherence tomography angiography (octA) between poAG and PACG eyes. Thirty-two POAG eyes, 30 PACG eyes, and 39 control eyes were included. All the optic disc VD parameters except the inside disc VD were significantly lower in glaucomatous eyes than in control eyes. Compared with PACG eyes, only the inferior temporal peripapillary VD was significantly lower in POAG eyes. The parafoveal VD was significantly lower in each quadrant in glaucomatous eyes than in control eyes. The central macular and parafoveal VD did not differ between POAG and PACG eyes. In conclusion, the inferior temporal peripapillary VD was significantly reduced in POAG eyes compared with PACG eyes, while PACG eyes showed a more evenly distributed reduction in the peripapillary VD. The distinct patterns of VD change may be associated with the different pathogenesis between poAG and pAcG. Glaucoma is an optic neuropathy characterised by progressive loss of retinal ganglion cells and their axons accompanied by corresponding visual field (VF) defects. Primary glaucoma is classified according to the anatomy of the anterior chamber angle into primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Elevated intraocular pressure (IOP) is the major risk factor for glaucoma. In PACG, elevated IOP secondary to angle closure is considered the primary mechanism. On the other hand, other non-IOP risk factors such as vascular abnormalities and lower systolic/diastolic perfusion pressure have been proposed in POAG 1-4. The characteristics of the optic disc are also different between POAG and PACG eyes. There may be enlarged cupping and/or optic disc rim notching in POAG eyes, whereas pallor of the optic disc either from an acute attack of angle closure or in the chronic clinical course may be observed in PACG eyes 5,6. All these findings indicate the distinct pathogenesis between POAG and PACG and reflect the feature of microvascular damage. Optical coherence tomography angiography (OCTA) is a reliable technique to perform in vivo imaging of the optic nerve head (ONH) and retinal microcirculation 7-11. Previous studies have reported reduced vessel density (VD) in the ONH, peripapillary area, and macula in glaucomatous eyes 12-17. Most of the studies investigated POAG eyes and had limited analyses for the microcirculation in PACG eyes 18-21. The diagnostic ability of VD as well as the relationship of peripapillary VD with VF and/or retinal nerve fibre layer (RNFL) thickness in POAG and PACG have been reported 18-28. To date, no reports have compared the pattern of regional VD change in the optic disc or macula b...

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 97%

Optic Disc and Macular Vessel Density Measured by Optical Coherence Tomography Angiography in Open-Angle and Angle-Closure Glaucoma

Hou

Kuang

et al. 2020

Sci Rep

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“…Choroidal but not retinal thinning has been shown in patients with established coronary artery disease (defined by angiographic coronary artery stenosis, a positive stress test, and/or previous coronary revascularization or myocardial infarction) compared with healthy subjects in small studies. 129,130 However, limited reporting of CVD risk factors, the inclusion patients with diabetes, and a high CVD risk control group weaken these associations. 129,130 A recent study using spectral domain OCT examined a subgroup of 764 elderly patients (mean age 82 years; two-thirds female patients) from a French population-based study (>9000 participants) and found no associations between subfoveal choroidal thickness and previous CVD, current CVD risk factors, or estimated future CVD risk according to a clinical scoring tool.…”

Section: The Chorioretinal Circulation: Cvd Risk Factors and Outcomesmentioning

confidence: 99%

“…129,130 However, limited reporting of CVD risk factors, the inclusion patients with diabetes, and a high CVD risk control group weaken these associations. 129,130 A recent study using spectral domain OCT examined a subgroup of 764 elderly patients (mean age 82 years; two-thirds female patients) from a French population-based study (>9000 participants) and found no associations between subfoveal choroidal thickness and previous CVD, current CVD risk factors, or estimated future CVD risk according to a clinical scoring tool. 131 A large amount of missing data, recall bias from patient-declared medical history, and a single manual measure of choroidal thickness may have contributed to these negative results.…”

Section: The Chorioretinal Circulation: Cvd Risk Factors and Outcomesmentioning

confidence: 99%

The eye, the kidney, and cardiovascular disease: old concepts, better tools, and new horizons

Farrah

Dhillon

Keane

et al. 2020

Kidney International

104

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Chronic kidney disease (CKD) is common, with hypertension and diabetes mellitus acting as major risk factors for its development. Cardiovascular disease is the leading cause of death worldwide and the most frequent end point of CKD. There is an urgent need for more precise methods to identify patients at risk of CKD and cardiovascular disease. Alterations in microvascular structure and function contribute to the development of hypertension, diabetes, CKD, and their associated cardiovascular disease. Homology between the eye and the kidney suggests that noninvasive imaging of the retinal vessels can detect these microvascular alterations to improve targeting of at-risk patients. Retinal vessel–derived metrics predict incident hypertension, diabetes, CKD, and cardiovascular disease and add to the current renal and cardiovascular risk stratification tools. The advent of optical coherence tomography (OCT) has transformed retinal imaging by capturing the chorioretinal microcirculation and its dependent tissue with near-histological resolution. In hypertension, diabetes, and CKD, OCT has revealed vessel remodeling and chorioretinal thinning. Clinical and preclinical OCT has linked retinal microvascular pathology to circulating and histological markers of injury in the kidney. The advent of OCT angiography allows contrast-free visualization of intraretinal capillary networks to potentially detect early incipient microvascular disease. Combining OCT’s deep imaging with the analytical power of deep learning represents the next frontier in defining what the eye can reveal about the kidney and broader cardiovascular health.

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“…Jin Wang et al [27] assessed the full retinal thickness, the vessel density and the flow area in several retinal layers of healthy and coronary heart disease (CHD) patients using OCT and OCTA. They concluded that OCTA is sensitive to detect a decrease in the vessel density in all retinal/choroidal layers and choroidal flow area before any clinical fundus sign showed in CHD patients, except for the superficial and deep fovea.…”

mentioning

confidence: 99%

Progress in Multimodal En Face Imaging: feature introduction

Podoleanu

Izatt

Lumbroso³

et al. 2019

Biomed. Opt. Express

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

Cited by 122 publications

References 39 publications

Optic Disc and Macular Vessel Density Measured by Optical Coherence Tomography Angiography in Open-Angle and Angle-Closure Glaucoma

Optic Disc and Macular Vessel Density Measured by Optical Coherence Tomography Angiography in Open-Angle and Angle-Closure Glaucoma

The eye, the kidney, and cardiovascular disease: old concepts, better tools, and new horizons

Progress in Multimodal En Face Imaging: feature introduction

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