The Deep Capillary Plexus of the Eye Mirrors the Heart in Terms of Microvascular Dysfunction: An Octa Study

Purpose: This study investigated retinal microvascular alterations using optical coherence tomography angiography (OCTA) in patients with coronary microvascular dysfunction (CMD), including slow coronary flow and ectatic coronary arteries. Methods: 174 eyes from 92 patients with CMD and 82 healthy control patients were included in the study. Routine ophthalmic examination was performed, and OCTA was employed to assess both the macula and optic disc. Vascular density of vessels in the superficial capillary plexus (SCP), deep capillary plexus (DCP) of the macula, and radial peripapillary capillaries (RPC) blood supply regions and the size of the foveal avascular zone (FAZ) was detected. Results: Univariate regression revealed significant differences in superficial capillary plexus (SCP), deep capillary plexus (DCP), and foveal avascular zone (FAZ) between CMD patients and healthy controls (all p<0.05). Multivariate analysis identified DCP as the sole independent predictor of CMD (OR(CI); 7.54 (2.69-21.12)). Conclusion: These findings align with existing literature demonstrating retinal-cardiovascular correlations and highlight DCP as a potential non-invasive biomarker for CMD, particularly in male patients. The results support OCTA's utility in cardiovascular risk stratification, with gender-specific patterns warranting further investigation in larger cohorts.