The Relation Of Retinal Vasculopathy And Coronary Artery Disease

Objective: we try to approach the clinical correlations of retinal vascular diameter retinal arteriole to venule ratio(AVR) and angiographic extent of coronary artery disease(CAD).Methods: From January 2007 to February 2008 in Beijing chui yang liu hospital, the patients(40~80years) suspected CAD or final diagnosis that come from CCU and cardiovascular diseases Department were selected to accept coronary arterio- graphy. According to Gensini score,we evaluate the degree and extent of coronary atherosclerosis. The diameter of individual retinal arterioles and venules coursing through a zone located 2disc diameter from the optic disc margin were measured on the computer by trained oculist who had no knowledge of the patients'coronary artery status.Results: 1 The 114 patients who lived in surrounding community of beijing chui yang liu hospital suspected CAD were selected, including 61 men and 53 women, and the age ranged from 40-80 years old (mean age 60.16±10.34 years old). The CHD group analyzed by coronary arteriongraphy include 85 patients with CHD and 29 patients without CHD. The discrepancy of comparison of age sex hypertension diabetes hyperlipemia TC and so on in two sets is not significant in statistics (P>0.05)2 The result of coronary arteriongraphy of CHD group:The CHD group analysised with coronary arteriongraphy include 85 patients(74.57%) with CHD by diagnostic criteria and 29 patients(25.43 %)without CHD. The mean Gensini score of the CHD group in men (57.93±12.81)was higher than the score in women(37.56±35.47) and the discrepancy of comparison of the different sex is significant in statistics(P<0.05). the discrepancy of comparison of the three subset groups is significant in statistics(P < 0.05). The discrepancy of comparison of the affiliated hypertension group and the simple CHD group is significant in statistics(P<0.05). The discrepancy of comparison of other groups is not significant in statistics(P>0.05).3 The result of retinal vasculopathy of our study:①The mean retinal vessel diameter: the discrepancy of comparison of the mean retinal arteriole diameter(upper temporal and inferior temporal branch) in CHD group is smaller than that in control groupP<0.05. The discrepancy of comparison of the mean retinal venule diameter(upper temporal and inferior temporal branch) in CHD group is larger than that in control groupP<0.05.②Mean retinal arteriole to venule ratio :The CHD group (upper temporal in right eye)0.66±0.13, (inferior temporal) 0.68±0.20; The control group(upper temporal ) 0.73±0.15; (inferior temporal) 0.72±0.26. The discrepancy of comparison of the mean retinal arteriole to venule ratio (upper temporal and inferior temporal branch) in CHD group is smaller than that in control group. The discrepancy of comparison of the mean retinal arteriole to venule ratio (upper temporal and inferior temporal branch) in CHD group is smaller than that in control group(P<0.05). The discrepancy comparison of the mean retinal arteriole to venule ratio (upper temporal and inferior temporal branch) in the multi-branch group is smaller than that in the single-branch group (P<0.05).4 The correlation analysis between retinal arteriole to venule ratio and the degree of coronary atherosclerosis: With Pearson correlation analysis to analyze the correlation of retinal arteriole to venule ratio and the degree of coronary atherosclerosis,we can see that retinal arteriole to venule ratio has negtive correlation of the degree and extent of coronary atherosclerosis. r(upper temporal)=–0.269 P<0.01; r(inferior temporal) =–0.256 P<0.05. with partial correlation analysis and controling hypertension diabetes and others influencing factors,we can see the negtive correlation is present still.5 The analysis between retinal arteriole to venule ratio and its influenced factors: after adjustment for age hypertension diabetes HDL-C,LDL-C,TG,TC and bying multiple regression analysis,we can see that retinal arteriole to venule ratio has negtive correlation of TC level. r(upper temporal) =–1.731,P<0.05;r(inferior temporal) =–1.566 P<0.05.Conclusion:The relation of retinal vessel diameter and AVR and the degree and extent of coronary atherosclerosis is well. The retinal artery diameter has significantly negtive correlation of Gensini score that the degree and extent of coronary atherosclerosis. The retinal venule diameter has significantly positive correlation of Gensini score that the degree and extent of coronary atherosclerosis. The AVR has significantly positive correlation of Gensini score.The parameter of retinal small vessel mybe a useful index to forecast CHD and the degree and extent of coronary atherosclerosis.