Jeremic Natasa, Esengönül Meltem, Zarghami Azin, Pawloff Maximilian, Hasun Matthias, Schreiner Markus, Windhager Reinhard, Niessner Alexander, Pollreisz Andreas, Bogunovic Hrvoje, Schmidt-Erfurth Ursula
Laboratory for Ophthalmic Image Analysis (OPTIMA), Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Invest Ophthalmol Vis Sci. 2025 Jul 1;66(9):27. doi: 10.1167/iovs.66.9.27.
Retinal imaging may offer a non-invasive method to detect coronary artery disease (CAD). Geometric perfusion deficits (GPDs), defined as intercapillary areas beyond 30 µm from the nearest vessel, were analyzed for their CAD association and topographical patterns.
Patients undergoing coronary angiography and healthy controls (mean ages: non-CAD, 58 ± 9 years; CAD, 61 ± 9 years) were assessed. Fovea-centered 6 × 6-mm optical coherence tomography angiography (OCTA) images were acquired, and the superficial capillary plexus was analyzed. GPD density, count, ischemic extent (IE), and top 10 GPD areas (MT10) were extracted. The Gensini score (GS) quantified CAD severity. Multivariate mixed-effects models were calculated for statistical analysis.
This study analyzed 237 patients (382 eyes), 141 (225 eyes) with CAD. Significant associations with the GS were found across all metrics after adjustments (density coefficient = 0.050, P = 0.001; IE coefficient = 0.002, P = 0.005; MT10 coefficient = 0.066, P = 0.005; count coefficient = 0.015, P = 0.003). The most profound changes were observed in the parafovea. Significant group differences were found between the non-CAD and moderate CAD groups, as well as between the non-CAD and severe CAD groups in the total image and the parafovea, temporal, and nasal outer segments. Moderate and severe CAD did not display significant differences. GPD metrics showed higher predictive abilities than conventional OCTA metrics.
Four GPD metrics were significantly associated with CAD, with the parafoveal area showing the highest significance and consistency. GPDs differed significantly between CAD and non-CAD patients.
视网膜成像可能提供一种检测冠状动脉疾病（CAD）的非侵入性方法。分析了几何灌注缺陷（GPDs），其定义为距最近血管超过30 µm的毛细血管间区域，以确定其与CAD的关联及地形模式。
对接受冠状动脉造影的患者和健康对照者（平均年龄：非CAD患者，58±9岁；CAD患者，61±9岁）进行评估。采集以中央凹为中心的6×6 mm光学相干断层扫描血管造影（OCTA）图像，并分析浅表毛细血管丛。提取GPD密度、计数、缺血范围（IE）和前10个GPD区域（MT10）。Gensini评分（GS）量化CAD严重程度。计算多变量混合效应模型进行统计分析。
本研究分析了237例患者（382只眼），其中141例（225只眼）患有CAD。调整后，所有指标均与GS存在显著关联（密度系数=0.050，P = 0.001；IE系数=0.002，P = 0.005；MT10系数=0.066，P = 0.005；计数系数=0.015，P = 0.003）。在黄斑旁区域观察到最显著的变化。在总图像、黄斑旁、颞侧和鼻外侧段，非CAD组与中度CAD组之间以及非CAD组与重度CAD组之间存在显著的组间差异。中度和重度CAD组之间未显示出显著差异。GPD指标显示出比传统OCTA指标更高的预测能力。
四个GPD指标与CAD显著相关，其中黄斑旁区域显示出最高的显著性和一致性。CAD患者和非CAD患者之间的GPD存在显著差异。
