Are retinal microvascular caliber changes associated with severity of coronary artery disease in symptomatic cardiac patients?
OBJECTIVE
Recent population-based studies have shown that retinal vascular caliber may predict the risk of clinical coronary artery disease (CAD) events. Whether this association is related to macro- or microvascular mechanisms remains unknown. We investigated the relationship of retinal vascular caliber with severity and extent of CAD in symptomatic cardiac patients.


METHODS
Overall, 98 patients attending diagnostic coronary angiography were recruited. Coronary angiography was used to assess for the severity and extent of CAD. Digital retinal photography was performed immediately prior to cardiac catheterization, and retinal vascular caliber was measured from these photographs by using a computer program and summarized as central retinal arteriolar (CRAE) and venular (CRVE) equivalents.


RESULTS
Retinal arteriolar and venular calibers were not associated with increasing severity of CAD, as assessed by Leaman scores (CRAE/CRVE: P for trend=0.17/0.57), presence of clinically significant CAD (CRAE/CRVE: P=0.35/0.32), or number of diseased vessels (CRAE/CRVE: P for trend=0.18/0.69).


CONCLUSIONS
Retinal vascular caliber changes are not associated with the severity of obstructive CAD in symptomatic patients. These data suggest that the association of retinal vascular caliber with clinical CAD seen in epidemiological studies may not be applicable to clinical symptomatic patients and may be related to microvascular, rather than macrovascular, mechanisms.
Kreis
Andreas Josef
AJ
Centre for Eye Research Australia, University of Melbourne, 145 Studley Road, Heidelberg, Victoria 3084, Australia.
Nguyen
Thanh Tan
TT
Wang
Jie Jin
JJ
Rogers
Sophie
S
Al-Fiadh
Ali
A
Freeman
Melanie
M
Wong
Tien Yin
TY
Farouque
H M Omar
HM
D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D012160:Retina / Q000473:pathology* / Q000503:physiopathology*; D012720:Severity of Illness Index; D014699:Venules / Q000473:pathology / Q000503:physiopathology