Evaluating choroidal biomarkers for cardiovascular risk prediction using the American Heart Associatiońs PREVENT score

Purpose To investigate the association between PREVENT, a cardiovascular disease (CVD) risk estimation model, and quantitative parameters derived from choroidal vascular imaging. Methods We conducted a retrospective study including 82 eyes from 82 patients aged 30 to 79 years who attended a standard ophthalmologic evaluation. Choroidal vascularity index (CVI), total choroidal area (TCA), luminal choroidal area (LCA), stromal choroidal area (SCA), and vessel density (VD) in the choriocapillaris (CC) and mid choroid, measured using swept-source optical coherence tomography angiography (SS-OCTA), were recorded. Results TCA, LCA, and SCA were significantly lower in the high-risk group compared to the low-risk group ( p value <0.001). Correlation analysis revealed a significant negative association between 10-year PREVENT scores and TCA, LCA, and SCA (r ≈ −0.350, p value <0.001), and between the 30-year PREVENT score and VD in the CC (r = -0.370, p value = 0.037). Conclusion This study provides initial evidence that choroidal structural and vascular parameters are inversely associated with long-term cardiovascular risk, suggesting their potential utility in the primary prevention of CVD. Further longitudinal studies with larger sample sizes are warranted to confirm these findings.