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

• Published in: Journal 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
• Language: English
• Published: United States Elsevier Inc 01.04.2024; Elsevier Limited
• Subjects: Coronary artery disease (CAD); Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary computed tomography angiography; Coronary vessels; Cross-Sectional Studies; Diabetes; Diabetes Mellitus; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - diagnostic imaging; Digital retinal imaging; Disease; Edema; Electronic health records; Female; Hospitals; Humans; Insulins; Male; Medical imaging; Medical records; Microvascular/macrovascular complications; Retina; Retinal Vessels - diagnostic imaging; Single-Blind Method; Tomography; Tomography, Optical Coherence - methods; Veins & arteries; Work stations; United States > US; Diabetic retinopathy; Microvascular/macrovascular complications; Coronary artery disease (CAD); Diabetes mellitus; Coronary computed tomography angiography; Digital retinal imaging
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2024.108721

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.