Retinal Ischemic Perivascular lesions Linked to Myocardial Infarction Risk in CAD Patients: Study

Retinal ischemic perivascular lesions (RIPLs) have garnered attention as potential biomarkers for retinal ischemia, reflecting underlying vascular pathology. However, their association with MI among CAD patients remains poorly understood. A recent retrospective cross-sectional study aimed to investigate this relationship using macular spectral domain optical coherence tomography (SD-OCT) imaging. This study was published in the American Journal Of Ophthalmology. The study was conducted by Elodie B. and colleagues.

The study included 317 consecutive CAD patients who underwent SD-OCT imaging of the macula. Patients with a history of MI were compared to those without MI. RIPLs were assessed by two independent graders, and medical records were reviewed. Multivariate logistic regression analysis was conducted to evaluate the association between RIPLs and MI, adjusting for relevant covariates.

The key findings of the study were:

• Prevalence of RIPLs: Among CAD patients, 17% had a history of MI, with a significantly higher prevalence of RIPLs observed in the MI group compared to the non-MI group (59.3% vs. 35.7%; p<0.001).

• Association with MI: Presence of RIPLs was strongly associated with MI, with an odds ratio of 3 (95% CI: 1.91-4.74; p<0.001), after adjusting for age, gender, smoking status, hypertension, diabetes, dyslipidemia, and body mass index.

The study findings highlight a significant association between RIPLs detected via SD-OCT imaging and MI in CAD patients. RIPLs may serve as valuable biomarkers for identifying individuals at heightened risk of cardiovascular events within this population. The incorporation of RIPL evaluation into routine clinical assessments could enhance risk stratification and inform targeted interventions to mitigate cardiovascular risk in CAD patients.

These findings underscore the importance of comprehensive cardiovascular evaluations in CAD patients, including assessment of retinal vascular changes. Early detection of RIPLs may facilitate proactive management strategies aimed at reducing the incidence of MI and improving patient outcomes in this high-risk population.

In conclusion, the presence of retinal ischemic perivascular lesions (RIPLs), as assessed by SD-OCT, is significantly associated with myocardial infarction in patients with coronary artery disease. These findings underscore the potential clinical utility of RIPL evaluation as part of the medical management of CAD, offering valuable insights into cardiovascular risk assessment and personalized intervention strategies. Further research is warranted to validate these findings and elucidate the underlying mechanisms linking RIPLs to MI in CAD patients.

Reference:

Bousquet, E., Santina, A., Au, A., Somisetty, S., Abraham, N., Voichanski, S., Estawro, R., Fouad, Y. A., Romero-Morales, V., Bakhoum, M. F., & Sarraf, D. (2024). Retinal Ischemic Perivascular Lesions are associated with myocardial infarction in patients with coronary artery disease. American Journal of Ophthalmology. https://doi.org/10.1016/j.ajo.2024.03.017