Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0192350
Title: Microvascular retinopathy and angiographically-demonstrated coronary artery disease: A cross-sectional, observational study
Authors: Cheng L.
Barlis P.
Gibson J.
Colville D.
Hutchinson A.
Gleeson G.
Lamoureux E. 
VanGaal W.
Savige J.
Keywords: adult
aged
Article
coronary angiography
coronary artery disease
coronary artery obstruction
cross-sectional study
diabetes mellitus
diabetic retinopathy
disease association
female
human
hypertension retinopathy
left anterior descending coronary artery
major clinical study
male
microvascular retinopathy
observational study
proliferative retinopathy
retina hemorrhage
retinopathy
sex ratio
complication
coronary artery disease
coronary blood vessel
diabetic retinopathy
diagnostic imaging
middle aged
pathology
pathophysiology
procedures
retina disease
venule
very elderly
Adult
Aged
Aged, 80 and over
Coronary Angiography
Coronary Artery Disease
Coronary Vessels
Cross-Sectional Studies
Diabetic Retinopathy
Female
Humans
Male
Middle Aged
Retinal Diseases
Venules
Issue Date: 2018
Citation: Cheng L., Barlis P., Gibson J., Colville D., Hutchinson A., Gleeson G., Lamoureux E., VanGaal W., Savige J. (2018). Microvascular retinopathy and angiographically-demonstrated coronary artery disease: A cross-sectional, observational study. PLoS ONE 13 (5) : e0192350. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0192350
Abstract: Epidemiological studies suggest retinal microvascular abnormalities predict cardiac events. This study examined microvascular features associated with coronary artery abnormalities. This was a single-centre, cross-sectional, observational study of 144 consecutive subjects undergoing coronary angiography for clinical indications. Their angiograms were deidentified and graded for disease (Leaman score, LAD stenosis 70%, number of vessels stenosed 70%), and Thrombolysis in Myocardial Infarction (TIMI) blush score. Subjects also underwent retinal photography (KOWA non-mydriatic camera, Japan), and their deidentified retinal images were graded for hypertensive microvascular retinopathy (Wong and Mitchell classification), vessel calibre using a computer-assisted method (IVAN, U Wisconsin), and diabetic retinopathy (modified Airlie House scheme) independently by a trained grader and an ophthalmologist. Retinal abnormalities were compared between subjects with high and low angiography scores using one way ANOVA, Chi squared and logistic regression analysis (StataCorp, Texas). Subjects had a mean age of 61 years (range 32–88), and included 101 males (70%). Seventeen (12%) had Leaman scores > 10.5, 46 (32%) had LAD stenosis, 13 (9%) had 3 arteries stenosed, and 20 (14%) had TIMI blush scores < 1. Twenty-six subjects (18%) had a retinal hemorrhage, and 115 (74%) a mild or moderate hypertensive retinopathy. Fifty-five (38%) had diabetes, and 24 (17%) a background (n = 20) or proliferative (n = 4) diabetic retinopathy. A retinal hemorrhage (p = 0.046), moderate microvascular retinopathy (p = 0.08) and proliferative diabetic retinopathy (p = 0.04) were all associated with a higher Leaman score. Venular calibre was increased with triple vessel disease (205.7 ± 21.6 ?m, and 193.7 ± 22.3 ?m in normals, p = 0.03). Diabetic retinopathy correlated with an increased TIMI blush score (p = 0.01). Retinal microvascular imaging warrants further evaluation in identifying the presence, extent and nature of coronary artery disease. © 2018 Cheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/161231
ISSN: 19326203
DOI: 10.1371/journal.pone.0192350
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