Abstract

Research Article

Investigation of Retinal Microvascular Findings in patients with Coronary Artery Disease

Tolga Doğan*, Osman Akın Serdar, Naile Bolca Topal and Özgür Yalçınbayır

Published: 07 July, 2017 | Volume 2 - Issue 1 | Pages: 042-049

Objectives: Retinal microvascular anomalies may be a marker for cardiovascular diseases. Our aim in this study was to investigate the utility of ocular fundoscopic examination as a noninvasive method in specifying the patients who carry a risk for coronary artery disease.

Material and Method: Patients who were diagnosed with coronary artery disease by coronary angiography were included in our study. Bilateral fundoscopic examination was performed in these patients. Fundoscopic findings and risk factors for coronary artery disease were evaluated.

Results: This study enrolled 100 patients (male: 72 (72%), mean age: 58.25±7.1) who were diagnosed with coronary artery disease by coronary angiography. Upon fundoscopic examination, 87% of the study population had atherosclerotic changes. Grade I atherosclerosis was found in 54% of the patients, grade II atherosclerosis was found in 32% of the patients and grade III atherosclerosis was found in 1% of the patients. Increased retinal tortuosity was present in 65% of the patients. Hollenhorst plaque was observed in 3 patients. Drusenoid bodies were observed with a statistically significantly higher rate in the patients who were not using clopidogrel compared to the patients who were using clopidogrel (p<0.001).

Conclusions: Retinal findings are frequently found in patients with coronary artery disease. Therefore, fundoscopic examination is a noninvasive and feasible examination method which can be frequently used in the evaluation of cardiac functions.

Read Full Article HTML DOI: 10.29328/journal.jccm.1001012 Cite this Article Read Full Article PDF

Keywords:

Coronary artery disease; Fundoscopic examination; Atherosclerosis

References

  1. Bonow RO, Smaha LA, Smith SC Jr, Mensah GA, Lenfant C. World Heart Day 2002: the international burden of cardiovascular disease: responding to the emerging global epidemic. Circulation. 2002; 106: 1602-1605. Ref.: https://goo.gl/QLe28G
  2. 2nd World Health Report 1999: Making a difference. Geneva: World Health Organization; 1999.
  3. Goto I, Katsuki S, Ikui H, Kimoto K, Mimatsu T. Pathological studies on the intracerebral and retinal arteries in cerebrovascular and noncerebrovascular diseases. Stroke. 1975; 6: 263-269. Ref.: https://goo.gl/vfNrvL
  4. Tedeschi-Reiner E, Strozzi M, Skoric B, Reiner Z. Relation of atherosclerotic changes in retinal arteries to the extent of coronary artery disease. Am J Cardiol. 2005; 96: 1107-1109. Ref.: https://goo.gl/USq7Uc
  5. Baim DS, Grossmann W. Coronary Angiography. In: Baim Grossmann, editor. Grossman’s Cardiac Catheterization, angiography, and Intervention. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2000; 211-257.
  6. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18: 499-502. Ref.: https://goo.gl/e2Nb9g
  7. Apple DJ, Naumann GO. Retina, In: Naumann GO, Apple DJ (eds). Pathology of the Eye. New York; Springer-Verlag; 1986; 580-583.
  8. Tedeschi-Reiner E, Strozzi M, Skoric B, Reiner Z. Relation of atherosclerotic changes in retinal arteries to the extent of coronary artery disease. Am J Cardiol. 2005; 96: 1107-1109. Ref.: https://goo.gl/KEskQ9
  9. Torpy JM, Glass TJ, Glass RM. JAMA patient page. Retinopathy. JAMA. 2005; 293: 128. Ref.: https://goo.gl/c4pwhU
  10. Cheung N, Bluemke DA, Klein R, Sharrett AR, Islam FM, et al. Retinal arteriolar narrowing and left ventricular remodeling: the multi-ethnic study of atherosclerosis. J Am Coll Cardiol. 2007; 50: 48-55. Ref.: https://goo.gl/e62Arb
  11. Lang GK. Ophthalmology: A Pocket Textbook Atlas. (Thieme, Stuttgart, 2007).
  12. Kelin R. Epidemiology. In age-related macular degeneration. In: Berger JW, Fine SL, Maguire MG. Eds. Philadelphia: Mosby. 1999; 31-55.
  13. Klein R, Klein BE, Linton KL, DeMets DL. The Beaver Dam Eye Study: the relation of age-related maculopathy to smoking. Am J Epidemiol. 1993; 137: 190-200. Ref.: https://goo.gl/Pnadtb
  14. Smith W, Mitchell P, Leeder SR. Smoking and age-related maculopathy. The Blue Mountains Eye Study. Arch Ophthalmol. 1996; 114: 1518-15123. Ref.: https://goo.gl/EBmPbX
  15. Christen WG, Glynn RJ, Ajani UA, Schaumberg DA, Chew EY, et al. Age-related maculopathy in a randomized trial of low-dose aspirin among US physicians. Arch Ophthalmol. 2001; 119: 1143-1149. Ref.: https://goo.gl/GcBGYG
  16. Cymerman RM, Skolnick AH, Cole WJ, Nabati C, Curcio CA, et al. Coronary Artery Disease and Reticular Macular Disease, a Subphenotype of Early Age-Related Macular Degeneration. Curr Eye Res. 2016; 41: 1482-1488. : https://goo.gl/YpiKih
  17. Ertugrul A. Diffuse tortuosity and lengthening of the arteries. Circulation. 1967; 36: 400-407. Ref.: https://goo.gl/hJE7ww
  18. Soikkonen K, Wolf J, Hietanen J, Mattila K. Three main arteries of the face and their tortuosity. Br J Oral Maxillofac Surg. 1991; 29: 395-398. Ref.: https://goo.gl/fx5MG6
  19. Dobrin PB, Schwarcz TH, Baker WH. Mechanism of arterial and aneurysmal tortuosity. Surgery. 1988; 104: 568-571. Ref.: https://goo.gl/DWGbqU
  20. Zegers ES, Meursing BTJ, Zegers EB. A.J.M oude ophuis coronary tortuosity: a long and winding road. Neth Heart J. 2007; 15: 191-195.
  21. Leipzig TJ, Dohrmann GJ. The tortuosity or kinked carotid artery: pathogenesis and clinical considerations. Surg Neurol. 1986; 25: 478-486. Ref.: https://goo.gl/w9NvFh
  22. Weibel J, Fields WS. Tortuosity, coiling, and kinking of the internal carotid artery: etiology and radiographic anatomy. Neurology. 1965; 15: 7-18. Ref.: https://goo.gl/3rtiFG
  23. Del Corso L, Moruzzo D, Conte B, Agelli M, Romanelli AM, et al. Tortuosity, kinking, and coiling of the carotid artery: expression of atherosclerosis or aging? Angiology. 1998; 49: 361-371. Ref.: https://goo.gl/ZwVtMa
  24. Zegers ES, Meursing BT, Zegers EB, Oude Ophuis AJ. Coronary tortuosity: a long and winding road. Neth Heart J. 2007; 15: 191-195. Ref.: https://goo.gl/PcfZVY
  25. Del Corso L, Moruzzo D, Conte B, Agelli M, Romanelli AM, et al. Tortuosity, kinking, and coiling of the carotid artery: expression of atherosclerosis or aging? Angiology. 1998; 49: 361-371. Ref.: https://goo.gl/ZwVtMa
  26. Owen CG, Rudnicka AR, Nightingale CM, Mullen R, Barman SA, et al. Retinal arteriolar tortuosity and cardiovascular risk factors in a multi-ethnic population study of 10 year old children; the Child Heart And health Study in England. Arterioscler Thromb Vasc Biol. 2011; 31: 1933-1938. Ref.: https://goo.gl/z6BBHh
  27. Brown GC, Magargal LE. Central retinal artery obstruction and visual acuity. Ophthalmology. 1982; 89: 14-19. Ref.: https://goo.gl/JfGTwF
  28. David NJ, Klintworth GK, Frieldberg SJ, Dillon M. Fetal Atheromatous cerebral embolism associated with bright plaques in the retinal arterioles. Report of a case. Neurology. 1963; 13: 708-713. Ref.: https://goo.gl/XmP6AL
  29. Hollenhorst RW, Lensink ER, Whisnant JP. Experimental Embolization of the Retinal Arterioles. Trans Am Ophthalmol Soc. 1962; 60: 316-334. Ref.: https://goo.gl/ryZffo
  30. Scolari F, Bracchi M, Valzorio B, Movilli E, Costantino E, et al. Cholesterol atheromatous embolism: an increasingly recognized cause of acute renal failure. Nephrol Dial Transplant. 1996; 11: 1607-1612. Ref.: https://goo.gl/pNArPE
  31. Poli A, Tremoli E, Colombo A, Sirtori M, Pignoli P, et al. Ultrasonographic measurement of the common carotid arterial wall thickness in hypercholestrolemic patients. Athresclerosis.1988; 70: 253-261. Ref.: https://goo.gl/FgjVC4
  32. Chambless LE, heiss G, Folsom Ar, rosamond W, Szklo M, et al. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987­-1993. Am J Epidemiol. 1997; 146: 483-494. Ref.: https://goo.gl/ruU6GR
  33. P Nikic, M Savic, V Jakovljevic, D Djuric. Carotid atherosclerosis, coronary atherosclerosis and carotid intima-media thickness in patients withischemic cerebral disease: Is there any link? Exp Clin Cardiol. 2006; 11: 102-106. Ref.: https://goo.gl/q45uLs

Figures:

Figure 1

Figure 1

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