The eye and acute coronary syndrome: Getting to the heart of the matter

(Image Credit: AdobeStock/ArLawKa)

Japanese investigators, led by Taiji Nagaoka, MD, PhD, have found an ocular biomarker of cardiovascular diseases. Specifically, in a recent study, the mean blur rate (MBR) in the nasal region was associated with systemic atherosclerosis in patients with acute coronary syndrome (ACS).

Dr. Nagaoka reported the findings at the Association for Research in Vision and Ophthalmology annual meeting. He is associate professor, Department of Ophthalmology, Nihon University School of Medicine, Tokyo.

This team of investigators reported previously the retinal blood flow parameters were associated with systemic atherosclerosis in patients with ACS. What remained unclear was the relationship between atherosclerosis and the choroidal blood flow parameters.

In a continuation of their research, the team used laser speckle flowgraphy (LSFG) to study the association between the choroidal blood flow and the systemic risk factors for atherosclerosis, ie, the brachial-ankle pulse-wave velocity (baPWV), an index of systemic arterial stiffness, and the intima-media thickness (IMT) in patients with ACS.

The study evaluated 44 patients between April 2019 and September 2020. The patients underwent a lipid panel study, renal function tests, cardiac function tests, measures of the INT and baPWV, and an ophthalmic evaluation.

Dr. Nagaoka explained that they used LSFG to measure the choroidal MBR as an index of choroidal blood flow nasally (MBR-N) from the disc without large retinal vessels and compared the results with the systemic risk factors including the baPWV and IMT.

LSFG results

“The results showed significant positive correlations between the baPWV and choroidal blood flow nasally (r=0.33, p=0.029), between the LVDd and choroidal blood flow temporally(r=-0.30, p=0.045), and between the LVmass index and the retinal blood flow (r=-0.45, p=0.002).

The study reached the following conclusions. The choroidal MBR in the nasal region is correlated with systemic arterial stiffness and is significantly lower in patients with coronary artery multivessel disease. Evaluation of the ocular blood flow using the noninvasive LSFG technology can detect systemic risk factors in patients with ACS.