The Eye as the Window to the Heart: Optical Coherence Tomography Angiography Biomarkers as Indicators of Cardiovascular Disease

Rebecca L. Kellner, Alon Harris, Lauren Ciulla, Giovanna Guidoboni, Alice Verticchio Vercellin, Francesco Oddone, Carmela Carnevale, Mohamed Zaid, Gal Antman, Jeffrey T. Kuvin, Brent Siesky

Research output: Contribution to journalReview articlepeer-review

Abstract

Alterations in microvasculature represent some of the earliest pathological processes across a wide variety of human diseases. In many organs, however, inaccessibility and difficulty in directly imaging tissues prevent the assessment of microvascular changes, thereby significantly limiting their translation into improved patient care. The eye provides a unique solution by allowing for the non-invasive and direct visualization and quantification of many aspects of the human microvasculature, including biomarkers for structure, function, hemodynamics, and metabolism. Optical coherence tomography angiography (OCTA) studies have specifically identified reduced capillary densities at the level of the retina in several eye diseases including glaucoma. This narrative review examines the published data related to OCTA-assessed microvasculature biomarkers and major systemic cardiovascular disease. While loss of capillaries is being established in various ocular disease, pilot data suggest that changes in the retinal microvasculature, especially within the macula, may also reflect small vessel damage occurring in other organs resulting from cardiovascular disease. Current evidence suggests retinal microvascular biomarkers as potential indicators of major systemic cardiovascular diseases, including systemic arterial hypertension, atherosclerotic disease, and congestive heart failure.

Original languageEnglish
Article number829
JournalJournal of Clinical Medicine
Volume13
Issue number3
DOIs
StatePublished - Feb 2024

Keywords

  • cardiovascular diseases
  • imaging
  • optical coherence tomography angiography

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