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Correlation Between Coronary Heart Disease and the Retinal Arteriovenous Ratio

  • Jun Wang
  • Qi Zhou
Chapter
Part of the Advances in Visual Science and Eye Diseases book series (AVSED, volume 3)

Abstract

Cardiovascular disease, especially the coronary heart disease, currently has the highest mortality. The main risk factors of the disease are high blood pressure, high blood lipid, age, family history, smoking, diabetes, obesity, etc. The retinal vessels are the only vessels in human body that are noninvasively observable in vivo that belong to small vessels and are a part of the microcirculation. Traditional ophthalmology only relies on the clinical staging of hypertensive or atherosclerotic retinopathy as clinical evidence for diagnosis and treatment. However from the cardio-cerebrovascular department’s perspective, evidences from retinal blood vessels are only references for early diagnose and judgment. If confined by the vertical thinking as practiced previously in isolated sub-disciplines, we will find that there are many questions unanswered; some of the macro questions are the following: Among all the risk factors in coronary heart disease, which factors are related with retinal vascular changes? What is the fundamental pathology of the various retinal vascular changes, respectively? If we view the research process of retinal vessel and cardio-cerebrovascular disease with the idea of integrative medicine in mind, we will find that it follows the philosophy of separation and integration, which means that they separate and integrate when the time comes and in a cycled way. In the beginning, due to the common histologic origin and the development of ophthalmoscope, rough retinal vascular evaluation became a window for specialists to evaluate the state of cardiovascular and cerebrovascular disease. Thanks to the development of bioengineering technology, the evaluation for retinal vascular changes became less invasive and more accurate. At the same time, basic experiments not only showed that the pathology behind different retinal vascular changes with different locations and patterns was different, but also that the cellular immune basis and physiologic effects of retinal artery and venous remodeling were different. Through combining the newest idea from the above disciplines, the population-based study had proved the correlation between different types of retinal microvascular changes and cardio-cerebrovascular diseases. This spurred researchers to hypothesize that it may be possible to predict hypertension or coronary heart disease based on changes in retinal microvessels. The concept of integrative medicine will help the complex relationship between retinal vascular changes and cardio-cerebrovascular diseases be researched in a comprehensive, three-dimensional, and multi-perspective way. The future development and combination of biomedical engineering, basic experiments, and epidemiological studies will make the individualized prevention and treatment possible.

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Copyright information

© Springer Nature Singapore Pte Ltd. and People's Medical Publishing House, PR of China 2020

Authors and Affiliations

  • Jun Wang
    • 1
  • Qi Zhou
    • 2
  1. 1.Department of OphthalmologyBeijing Anzhen Hospital, Capital Medical UniversityBeijingChina
  2. 2.Department of OphthalmologyPeking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

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