Retinal microcirculation parameters assessed by optical coherence tomography angiography as predictors of cardiovascular risk

Background. Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. Early diagnosis and risk stratification in individuals without clinically manifest pathology is of particular importance. Retinal microcirculation parameters ob tained using optical coherence tomography angiography (OCTA) are regarded as promising noninvasive biomarkers of subclinical vascular dysfunction. Purpose: To assess the diagnostic value of retinal microcirculation parameters for detecting microvascular alterations in individuals without established cardiovascular disease and to determine their association with cardiovascular risk level. Materials and methods. The study included 220 patients aged 35–65 years with no clinical signs of CVD. All subjects underwent comprehensive clinical and laboratory evaluation, cardiovascular risk assessment using the SCORE2 algorithm, and retinal OCTA with quantitative analysis of vascular parameters. Results. Participants with moderate and high cardiovascular risk demonstrated a decrease in vessel density and vessel length in the macular region, enlargement of the foveal avascular zone (FAZ) area, an increased FAZ acircularity index, and expansion of flow voids within the choriocapillaris layer. Statistically significant correlations were identified between OCTA parameters and blood pressure, lipid profile, and SCORE2-derived cardiovascular risk. Conclusion. OCTA-derived metrics have high prognostic value for evaluating subclinical vascular dysfunction. Their application may facilitate the early detection of microvascular impairment and enable more accurate cardiovascular risk stratification in individuals without overt clinical manifestations of disease.

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