What question did this study set out to answer?

The aim is to investigate whether patients with coronary microvascular dysfunction exhibit retinal ganglion cell degeneration.

February 8, 2026

Retinal ganglion cell dysfunction in patients with coronary microvascular dysfunction

Key Points

The aim is to investigate whether patients with coronary microvascular dysfunction exhibit retinal ganglion cell degeneration.
Participants underwent functional coronary angiography and 24-hour blood pressure monitoring.
Ophthalmic screening included optical coherence tomography scans of the optic nerve and macula.
The study compared retinal nerve fiber layer and ganglion cell complex thicknesses between CMD patients and controls.
Multivariable linear mixed models were used to analyze outcomes, controlling for various factors.
Inferior retinal nerve fiber layer was thinner in CMD patients compared to controls.
The day-to-night pulse pressure index difference mediated the relationship between CMD and RNFL thickness.
Higher pulse pressure index correlated with thinner retinal nerve fiber layer and ganglion cell complex.
CMD patients showed a notable lack of nocturnal blood pressure dipping compared to controls.

Abstract

Abstract Introduction Glaucoma is an ophthalmic disease characterized by retinal ganglion cell (RGC) degeneration and leading to progressive and irreversible vision loss. Microvascular dysfunction is a risk factor for glaucoma, due to disrupted autoregulation, increased arteriolar resistance, and decreased blood supply to the RGCs. Nocturnal blood pressure (BP) dipping has also been linked to negative glaucomatous outcomes. We hypothesized that patients with coronary microvascular dysfunction (CMD) attributed to microvascular dysfunction may present with RGC degeneration. We compared the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses between INOCA patients and controls and we examined whether the 24-hour BP profile can explain any observed differences. Materials 0.05). Higher PPi only correlated with thinner total, inferior, and superior GCC (all P values 0.05). Conclusions CMD patients show early RGC degeneration, associated with less pronounced nocturnal DBP drop, compared to SBP drop. We conjecture that these patients present with a generalized microvascular dysfunction phenotype. Our findings support that vascular damage precede, and not only follow, glaucomatous neurodegeneration.CMD thinner Inferior peripapillary RNFL Bolus thermodilution

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