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视网膜成像作为洞察心血管健康的窗口:迈向利用视网膜分析实现精准心血管医学

Retinal Imaging as a Window into Cardiovascular Health: Towards Harnessing Retinal Analytics for Precision Cardiovascular Medicine.

作者信息

Bisen Jay Bharatsingh, Sikora Hayden, Aneja Anushree, Shah Sanjiv J, Mirza Rukhsana G

机构信息

Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.

Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.

出版信息

J Cardiovasc Dev Dis. 2025 Jun 17;12(6):230. doi: 10.3390/jcdd12060230.

Abstract

Rising morbidity and mortality from cardiovascular disease (CVD) have increased interest in precision and preventive management to reduce long-term sequelae. While retinal imaging has traditionally been recognized for identifying vascular changes in systemic conditions such as hypertension and type 2 diabetes mellitus, a new ophthalmologic field, cardiac-oculomics, has associated retinal biomarker changes with other cardiovascular diseases with retinal manifestations. Several imaging modalities visualize the retina, including color fundus photography (CFP), optical coherence tomography (OCT), and OCT angiography (OCTA), which visualize the retinal surface, the individual retinal layers, and the microvasculature within those layers, respectively. In these modalities, imaging-derived biomarkers can present due to CVD and have been linked to the presence, progression, or risk of developing a range of CVD, including hypertension, carotid artery disease, valvular heart disease, cerebral infarction, atrial fibrillation, and heart failure. Promising artificial intelligence (AI) models have been developed to complement existing risk-prediction tools, but standardization and clinical trials are needed for clinical adoption. Beyond risk estimation, there is growing interest in assessing real-time cardiovascular status to track vascular changes following pharmacotherapy, surgery, or acute decompensation. This review offers an up-to-date assessment of the cardiac-oculomics literature and aims to raise awareness among cardiologists and encourage interdepartmental collaboration.

摘要

心血管疾病(CVD)发病率和死亡率的不断上升,使得人们对精准和预防性管理的兴趣增加,以减少长期后遗症。虽然视网膜成像传统上一直被认为可用于识别全身性疾病(如高血压和2型糖尿病)中的血管变化,但一个新的眼科领域——心脏眼科学,已将视网膜生物标志物变化与其他有视网膜表现的心血管疾病联系起来。几种成像方式可对视网膜进行可视化,包括彩色眼底摄影(CFP)、光学相干断层扫描(OCT)和OCT血管造影(OCTA),它们分别可对视网膜表面、各个视网膜层以及这些层内的微血管系统进行可视化。在这些成像方式中,由成像得出的生物标志物可能因CVD而出现,并已与一系列CVD的存在、进展或发生风险相关联,这些疾病包括高血压、颈动脉疾病、心脏瓣膜病、脑梗死、心房颤动和心力衰竭。已经开发出了有前景的人工智能(AI)模型来补充现有的风险预测工具,但临床应用还需要标准化和进行临床试验。除了风险评估外,人们对评估实时心血管状态以跟踪药物治疗、手术或急性失代偿后的血管变化的兴趣也在不断增加。本综述对心脏眼科学文献进行了最新评估,旨在提高心脏病专家的认识,并鼓励跨部门合作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0046/12194434/0bd02e1afcba/jcdd-12-00230-g001.jpg

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