Retinal Ischemic Perivascular Lesions are associated with myocardial infarction in patients with coronary artery disease

Am J Ophthalmol. 2024 Mar 27:S0002-9394(24)00122-3. doi: 10.1016/j.ajo.2024.03.017. Online ahead of print.

Abstract

Purpose: To evaluate the association of retinal ischemic perivascular lesions (RIPLs) with myocardial infarction (MI) among patients diagnosed with coronary artery diseases (CAD).

Design: Retrospective cross-sectional study.

Methods: Consecutive patients (317 patients) with CAD who underwent macular spectral domain optical coherence tomography (SD-OCT) were captured. Patients with CAD who developed MI were compared to those without MI. SD-OCT were reviewed by two independent and masked graders for the presence of RIPLs. Medical records were reviewed. Multivariate logistic regression analysis was used to evaluate the relationship between RIPLs and MI including the following covariates age, gender, smoking status, hypertension, diabetes, dyslipidemia and body mass index.

Results: Of 317 patients with CAD for whom OCT scans were available to study, there were 54 (17%) with a history of MI. A higher prevalence of RIPLs was observed in the MI group compared to the non-MI group (59.3% vs. 35.7%; p<0.001). Presence of RIPLs was significantly associated with MI with an odds ratio of 3 (1.91-4.74; p<0.001), after adjusting for age, gender, smoking status, hypertension, diabetes, dyslipidemia and body mass index.

Conclusion: The presence of RIPLs, detected with SD-OCT, is significantly associated with MI in patients with CAD. These findings underscore the potential clinical utility of incorporating RIPL evaluation in the medical management of CAD.