[Jeong Shim-kyo’s Reading My Body]
“The retina of the eye is the only organ where blood vessels can be directly observed inside the body. A recent study found that the distribution of blood vessels in the retina, specifically the vascular density, can gauge the risk of cardiovascular diseases.”
A research team from Seoul Asan Medical Center, including ophthalmologists Young-hee Yoon and Ji-myung Yang, cardiologist Seung-hwan Lee, and radiologist Dong-hyun Yang, conducted a study on 1,286 adults who had undergone retinal vascular examinations due to ophthalmic conditions and had a higher risk of cardiovascular diseases due to family history and other factors. The results showed that the group with the lowest retinal vascular density had up to a threefold higher risk of coronary artery narrowing and atherosclerosis compared to the group with the highest density.
Atherosclerosis is a condition where plaque, consisting of fats and cholesterol, builds up inside the coronary arteries, which supply blood to the heart, gradually narrowing the vessels. If this state persists, it can lead to inadequate oxygen supply to the heart and brain, and if the plaque ruptures, it can suddenly block the vessels, causing potentially fatal results such as myocardial infarction or cerebral infarction.
The research team analyzed 1,286 adults from 2015 to 2020 who underwent coronary CT scans due to risks of cardiovascular diseases from family history and lifestyle habits and also had retinal vascular imaging (optical coherence tomography angiography, OCTA) conducted for ophthalmic conditions. They found that lower retinal vascular density was associated with significant increases in atherosclerosis indicators such as coronary calcium scores, plaque presence, and degree of vascular stenosis. Notably, the vascular density in the superficial capillary plexus, where capillaries spread out near the retinal surface like a network, was identified as a strong predictor of atherosclerosis.
In the group with the lowest vascular density in the superficial capillary plexus, the risk of atherosclerosis was up to more than three times higher than in the highest density group. The risk of obstructive coronary artery disease (where coronary arteries are narrowed by 50% or more) was about 2.9 times higher, and the risk of severe coronary artery disease (where arteries are narrowed by 70-90%) was about 3.3 times higher, with a threefold increase in the risk of severe vascular stenosis.
While other organs require invasive examinations to observe blood vessels, retinal blood vessels can be directly examined with simple imaging. Low retinal vascular density suggests poor systemic blood flow. The research team interpreted this as being connected to coronary arteries, indicating that retinal vascular density could serve as an indicator reflecting the risk of cardiovascular diseases.
Based on this research, individuals with low retinal vascular density are expected to receive additional cardiac examinations in clinical settings to assess cardiovascular risk, leading to early diagnosis and prevention of cardiovascular diseases.
Professor Young-hee Yoon from Seoul Asan Medical Center’s Department of Ophthalmology stated, “This study is significant for its large-scale analysis of whether retinal vascular examinations can predict coronary atherosclerosis in asymptomatic adults. Retinal vascular examinations can be naturally utilized in ophthalmology clinics, potentially becoming a new method for early screening of cardiovascular diseases.”
Professor Seung-hwan Lee from Seoul Asan Medical Center’s Department of Cardiology commented, “Coronary atherosclerosis is dangerous as it often lacks symptoms but can suddenly block blood circulation. Even if asymptomatic now, if you have a family history or lifestyle factors increasing cardiovascular risk or low retinal vascular density, it’s recommended to undergo regular examinations and treatments as coronary CT scans might show progression of atherosclerosis.”
This research was published in a recent issue of the global academic journal ‘JAMA Cardiology.’