JAMA Cardiol

Retinal imaging may uncover hidden coronary artery disease

September 22, 2025

Study details: This cross-sectional cohort study evaluated 1,286 asymptomatic adults undergoing coronary CT angiography and retinal optical coherence tomography angiography (OCTA) at Asan Medical Center in South Korea. Researchers assessed associations between parafoveal vascular density (PFVD) in the superficial and deep capillary plexuses and coronary atherosclerosis burden, including calcium scores, plaque characteristics, and stenosis/involvement scores.

Results: Lower PFVD, especially in the superficial capillary plexus, was significantly associated with higher coronary artery calcium scores, greater plaque burden, and increased odds of obstructive and severe coronary artery disease. The lowest quartile of superficial PFVD was associated with nearly 3-fold higher odds of obstructive CAD (adjusted odds ratio [aOR], 2.91) and over 3-fold higher odds of severe CAD (aOR 3.30) compared with the highest quartile. Adding PFVD to traditional cardiovascular risk models improved diagnostic performance, with areas under the curve (AUCs) up to 0.79 for severe CAD.

Clinical impact: OCTA-derived PFVD may serve as a noninvasive biomarker for subclinical coronary atherosclerosis, enhancing risk stratification in asymptomatic individuals. Retinal imaging could complement traditional cardiovascular screening, especially in resource-limited or preventive care settings.

Source:

Yang JM, et al. (2025, September 17). JAMA Cardiol. Subclinical Coronary Atherosclerosis and Retinal Optical Coherence Tomography Angiography. https://pubmed.ncbi.nlm.nih.gov/40960791/