SAN DIEGO, Calif. — Cardiovascular disease may produce a biomarker that doctors can find in an eye exam, a recent study finds. Researchers at the Shiley Eye Institute at UC San Diego Health say an optical coherence tomography scan (or OCT) may be able to detect cardiovascular disease via tiny lesions in a person’s retina.
“The eyes are a window into our health, and many diseases can manifest in the eye; cardiovascular disease is no exception,” says lead author Mathieu Bakhoum, MD, PhD, a physician-scientist and retina surgeon at UC San Diego Health, in a university release.
“Ischemia, which is decreased blood flow caused by heart disease, can lead to inadequate blood flow to the eye and may cause cells in the retina to die, leaving behind a permanent mark. We termed this mark ‘retinal ischemic perivascular lesions,’ or RIPLs, and sought to determine if this finding could serve as a biomarker for cardiovascular disease.”
More lesions raise heart disease risk
For the study, researchers analyzed records of patients receiving OCT scans between July 2014 and 2019. One group contained 84 patients diagnosed with heart disease and the other group contained 76 healthy “control” individuals. Among the group with heart disease, study authors spotted more RIPLs in the retina, which led the team to believe that cardiovascular disease has a connection to increasing number of RIPLs.
“The only way we can visualize the smallest blood vessels in the body is in the eye. The retina in particular provides important evidence of the adverse effects of cardiovascular issues, such as high blood pressure,” adds Anthony DeMaria, MD.
“It’s my hope that the presence of RIPLs in the eye will serve as a marker for cardiovascular disease when patients are undergoing assessment of risk factors for heart disease, or when patients are undergoing evaluation for the suspected presence of heart disease.”
Usually, an individual’s risk of heart disease can be detected by a device called the atherosclerotic cardiovascular disease (ASCVD) risk score calculator that is based on guidelines set nationally by the American College of Cardiology. The device can assess an individual’s risk of heart attack or stroke within a period of 10 years. According to the study, an increased risk score from the ASCVD ties in with having a higher number of RIPLs.
“Individuals with low and borderline ASCVD scores had a low number of RIPLs in their eyes, but as the ASCVD risk increased, so did the number of RIPLs,” Bakhoum says.
Eye exams may lead to earlier heart treatment
DeMaria says detecting RIPLs could lead to earlier cardiovascular disease diagnoses, enabling patients to receive early therapy and preventative measures. This may even reduce the number of heart attacks or strokes.
Doctors recommend that patients with an increased number of RIPLs go see a cardiologist. Researchers add their goal is to make RIPLs official biological markers for cardiovascular disease and that the number of RIPLs should be part of the risk score of the ASCVD.
“Globally, cardiovascular disease is the number one cause of death and unfortunately many people are unaware they may have heart issues,” Bakhoum concludes. “The key in preventing this is early detection and treatment. It’s our hope that by identifying RIPLs as a marker for cardiovascular disease providers will be able to identify heart issues before a catastrophic event, such as a heart attack or a stroke, occurs.”
The findings appear in The Lancet’s EClinical Medicine.