Association between obstructive coronary disease and diabetic retinopathy: Cross-sectional study of coronary angiotomography and multimodal retinal imaging

To investigate the association between diabetic retinopathy (DR) and coronary artery disease (CAD) using coronary angiotomography (CCTA) and multimodal retinal imaging (MMRI) with ultra-widefield retinography and optical coherence tomography angiography and structural domain. Single-center, cross-se...

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Published inJournal of diabetes and its complications Vol. 38; no. 4; p. 108721
Main Authors Campos, Andre Chateaubriand, Lima, Eduardo Gomes, Jacobsen, Peter Karl, Arnould, Louis, Lottenberg, Simao, Maia, Renata Martins, Conci, Livia Silva, Minelli, Tomas, Morato, Andrea, Dantas-Jr, Roberto Nery, Nomura, Cesar Higa, Rissoli, Pedro, Pimentel, Sergio Gianotti, Serrano Junior, Carlos Vicente
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.04.2024
Elsevier Limited
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Summary:To investigate the association between diabetic retinopathy (DR) and coronary artery disease (CAD) using coronary angiotomography (CCTA) and multimodal retinal imaging (MMRI) with ultra-widefield retinography and optical coherence tomography angiography and structural domain. Single-center, cross-sectional, single-blind. Patients with diabetes who had undergone CCTA underwent MMRI. Uni and multivariate analysis were used to assess the association between CAD and DR and to identify variables independently associated with DR. We included 171 patients, 87 CAD and 84 non-CAD. Most CAD patients were males (74 % vs 38 %, P < 0.01), insulin users (52 % vs 38 %, p < 0.01) and revascularized (64 %). They had a higher prevalence of DR (48 % vs 22 %, p = 0.01), microaneurysms (25 % vs 13 %, p = 0.04), intraretinal cysts (22 % vs 8 %, p = 0.01) and areas of reduced capillary density (46 % vs 20 %, p < 0.01). CAD patients also had lower mean vascular density (MVD) (15.7 % vs 16.5,%, p = 0.049) and foveal avascular zone (FAZ) circularity (0.64 ± 0.1 vs 0.69 ± 0.1, p = 0.04). There were significant and negative correlations between Duke coronary score and MVD (r = −0.189; p = 0.03) and FAZ circularity (r = −0,206; p = 0.02). CAD, DM duration and insulin use independently associated with DR. CAD patients had higher prevalence of DR and lower MVD. CAD, DM duration and insulin use were independently associated with DR. •Coronary artery disease (CAD) and diabetic retinopathy are associated.•Multimodal retinal imaging and coronary angiotomography reveal novel findings.•Mean vascular density and circularity of the FAZ are lower in CAD patients.•Severity of macrovascular and microvascular complications correlated positively.•Cardiovascular stratification and artificial intelligence are promising uses.
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ISSN:1056-8727
1873-460X
DOI:10.1016/j.jdiacomp.2024.108721