OCTA-Derived Retinal Biomarkers for Cardiovascular Risk Stratification: A Narrative Review

Abstract

Optical Coherence Tomography Angiography (OCTA) is transforming the way we understand the connection between retinal health and cardiovascular disease (CVD). The retina, often considered a reflection of systemic vascular health, provides a non-invasive way to assess microvascular changes that may indicate early signs of cardiovascular issues. This review explores OCTA's potential in detecting subtle retinal alterations that could serve as biomarkers for CVD risk and early diagnosis.

To explore this, a comprehensive literature review was conducted, drawing from databases like PUBMED-MEDLINE, Scopus, and Google Scholar, covering studies from 2015 to 2024. Research focused on retinal vascular changes in individuals with CVD and how OCTA-derived parameters could serve as diagnostic indicators. The findings suggest that specific microvascular changes such as reduced vessel density, capillary dropout, and modifications in the foveal avascular zone are associated with systemic vascular dysfunction. These alterations are particularly linked to conditions like hypertension, diabetes, and atherosclerosis, reinforcing the idea that retinal imaging could be a valuable tool in cardiovascular risk assessment.

With its ability to provide high-resolution, real-time insights into retinal microvasculature, OCTA emerges as a promising tool in bridging ophthalmology and cardiology. As research continues to refine the role of retinal biomarkers in CVD detection, integrating OCTA into routine cardiovascular risk assessment could enhance early diagnosis and monitoring strategies. Standardization of OCTA-derived metrics will be key to making this technology a mainstream part of cardiovascular healthcare in the future.