Retina (Philadelphia, Pa.) · 2026
Expanded Field Optical Coherence Tomography Angiography Biomarkers Associated with Future Cardiovascular Disease and Mortality in Patients with Diabetic Retinopathy.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Lu Edward S, Cui Ying, Phu Krystal K, Ding Xinyi, Nodecker Kayla N, Le Rongrong, Zhu Ying, Garg Itika, Baldwin Grace, Rodriguez Jocelyn, Finn Matthew J, Razavi Peyman, Laíns Inês, Wu David M, Husain Deeba, Kim Leo A, Patel Nimesh A, Vavvas Demetrios G, Miller John B
Аннотация
PURPOSE: To explore associations among expanded field swept-source optical coherence tomography angiography metrics and the development of myocardial infarction, congestive heart failure (CHF), and all-cause mortality in diabetic patients with and without diabetic retinopathy (DR).
METHODS: Baseline swept-source optical coherence tomography angiography images (6 × 6 mm, Montage 15 × 15 mm) were assessed for quantitative and qualitative metrics to identify parameters associated with myocardial infarction, CHF, and all-cause mortality.
RESULTS: One hundred and seventy-eight eyes from 119 adults with diabetes without DR or with nonproliferative DR or proliferative DR were included (median 44 months, range 3-57 months). Eleven participants (9.2%) had a cardiovascular event (six myocardial infarction, five CHF) and seven (5.9%) died. Neovascularization vessel density (HR = 44.0, 95% confidence interval [CI]: 1.0-1,861.2, P = 0.048) and vitreous hemorrhage (HR = 39.7, 95% CI: 4.0-392.8, P = 0.002) were associated with CHF. Vitreous hemorrhage (HR = 13.5, 95% CI: 3.0-61.2, P = 0.001) and prior treatment with anti-vascular endothelial growth factor injections and panretinal photocoagulation (HR = 11.4, 95% CI: 2.0-66.3, P = 0.007) were associated with cardiovascular disease (CHF or myocardial infarction). Increased skeletonized vessel density of the deep capillary plexus (HR = 1.2, 95% CI: 1.0-1.5, P = 0.026) was associated with mortality.
CONCLUSION: Neovascularization vessel density and skeletonized vessel density of the deep capillary plexus on swept-source optical coherence tomography angiography are associated with cardiovascular disease and mortality in patients with DR. These exploratory findings suggest that swept-source optical coherence tomography angiography may be a useful noninvasive tool to identify diabetic patients at increased risk of cardiovascular disease and death.
METHODS: Baseline swept-source optical coherence tomography angiography images (6 × 6 mm, Montage 15 × 15 mm) were assessed for quantitative and qualitative metrics to identify parameters associated with myocardial infarction, CHF, and all-cause mortality.
RESULTS: One hundred and seventy-eight eyes from 119 adults with diabetes without DR or with nonproliferative DR or proliferative DR were included (median 44 months, range 3-57 months). Eleven participants (9.2%) had a cardiovascular event (six myocardial infarction, five CHF) and seven (5.9%) died. Neovascularization vessel density (HR = 44.0, 95% confidence interval [CI]: 1.0-1,861.2, P = 0.048) and vitreous hemorrhage (HR = 39.7, 95% CI: 4.0-392.8, P = 0.002) were associated with CHF. Vitreous hemorrhage (HR = 13.5, 95% CI: 3.0-61.2, P = 0.001) and prior treatment with anti-vascular endothelial growth factor injections and panretinal photocoagulation (HR = 11.4, 95% CI: 2.0-66.3, P = 0.007) were associated with cardiovascular disease (CHF or myocardial infarction). Increased skeletonized vessel density of the deep capillary plexus (HR = 1.2, 95% CI: 1.0-1.5, P = 0.026) was associated with mortality.
CONCLUSION: Neovascularization vessel density and skeletonized vessel density of the deep capillary plexus on swept-source optical coherence tomography angiography are associated with cardiovascular disease and mortality in patients with DR. These exploratory findings suggest that swept-source optical coherence tomography angiography may be a useful noninvasive tool to identify diabetic patients at increased risk of cardiovascular disease and death.