Faculty of Medicine of the University of Porto, Porto, Portugal.
Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal.
Acta Ophthalmol. 2022 Feb;100(1):e1-e15. doi: 10.1111/aos.14851. Epub 2021 Mar 29.
Cardiovascular (CV) disease (CVD) is the main cause of death around the world, and assessing a patient's CV risk factors (CVRF) can play a major role in its prevention. Since it has been shown that retinal vascular alterations may reflect several systemic processes such as CVRF, we conducted a systematic review in order to summarize which ocular microvasculature changes can be found using Optical Coherence Tomography Angiography (OCTA) in patients without ocular diseases and with systemic pathologies/conditions that affect the CV system when compared to healthy subjects. We searched on online databases, namely PubMed, Scopus, Cochrane and Web of Science, and obtained additional studies through citation tracking. Case reports and review articles were excluded. A total of 47 articles were included in our review. We describe that patients with hypertension, diabetes mellitus, kidney disease, preeclampsia, coronary artery disease, carotid artery stenosis and obstructive sleep apnoea syndrome have, in general, lower retinal and choroidal Vessel Density (VD) and Length (VL), as well as an increased foveal avascular zone area and perimeter. Additionally, several characteristics and/or conditions in healthy subjects, such as smoking status, hyper or hypoxia conditions, race, among others, are also related to ocular vascular changes and should be accounted for. We concluded that OCTA could be a useful tool to assess a patient's CV risk profile in a non-invasive way, possibly integrating the diagnostic and prognostic algorithms of the most prevalent CV diseases in the future.
心血管疾病（CVD）是全球主要的死亡原因，评估患者的心血管危险因素（CVRF）可以在其预防中发挥重要作用。由于已经表明视网膜血管改变可能反映出多种全身过程，例如 CVRF，因此我们进行了系统评价，以总结在没有眼部疾病且患有影响心血管系统的系统性疾病/病症的患者中，可以通过光学相干断层扫描血管造影（OCTA）发现哪些眼部微血管变化与健康受试者相比。我们在在线数据库（即 PubMed、Scopus、Cochrane 和 Web of Science）上进行了搜索，并通过引文追踪获得了其他研究。排除病例报告和综述文章。我们的综述共纳入了 47 篇文章。我们描述了患有高血压、糖尿病、肾病、先兆子痫、冠心病、颈动脉狭窄和阻塞性睡眠呼吸暂停综合征的患者，其视网膜和脉络膜血管密度（VD）和长度（VL）普遍较低，并且中心凹无血管区的面积和周长增加。此外，健康受试者中的一些特征和/或情况，如吸烟状况、高或低氧条件、种族等，也与眼部血管变化有关，应该考虑到这些因素。我们得出结论，OCTA 可能是一种有用的工具，可以以非侵入性的方式评估患者的心血管风险状况，可能会在未来整合最常见的心血管疾病的诊断和预后算法。
