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  • Use of OCT-A to Evaluate Acute Coronary Syndrome

    By Lynda Seminara
    Selected By: Deepak P. Edward, MD
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    Journal Highlights

    Investigative Ophthalmology & Visual Science
    2018;59(10):4299-4306

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    Microcirculation abnormalities con-tribute to processes that induce isch­emic coronary heart disease. Although various devices can quantify microvas­cular perfusion, most entail invasive techniques. Arnould et al. conducted a pilot study of retinal examination with optical coherence tomography angi­ography (OCT-A) to see whether this noninvasive technology could provide information about the cardiovascular profile of patients with acute coronary syndrome (ACS). Their findings showed that inner vascular density measured by OCT-A coincides with cardiovascular risk profile and left ventricular ejection fraction (LVEF).

    This prospective study was per­formed at Dijon University Hospital in France. Within 2 days of hospital admission, each patient underwent OCT-A, during which the vascular den­sity of the superficial retinal capillary plexus was measured. Patients were grouped into tertiles, from lowest to highest retinal vascular density (RVD).

    Overall, 237 cases were analyzed. Patients in the first (lowest) RVD tertile were older and were more likely to have diabetes and systemic hypertension than were patients in the third tertile. The first tertile also had greater Amer­ican Heart Association (AHA) risk, higher Global Registry of Acute Coro­nary Events (GRACE) scores, and lower LVEF. Multivariate analysis showed that, among the first tertile, associations between AHA risk score and LVEF were significant. A link between RVD and a high-risk cardiovascular profile was confirmed by the moderate correlation with GRACE scores.

    To the authors’ knowledge, this is the first study of the potential utility of retinal examination with OCT-A to gauge cardiovascular risk in patients with ACS. Results suggest that retinal vascular density may be a biomarker of overall microvascular status and cardiovascular risk. Larger studies are needed for validation.

    The original article can be found here.