The research status and progress of ocular manifestations related to acute coronary syndromes_Chinese Journal of Ocular Fundus Diseases

Authors：

Cheng Xueru , Wu Lanting , Wang Yanling ,  Wang Jialin

Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;

Corresponding author：

Wang Jialin, Email: wangjialin@bjmu.edu.cn

Keywords：

Acute coronary syndromes; Retinal diseases; Review

DOI：

10.3760/cma.j.cn511434-20211215-00702

Video：

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Acute coronary syndromes (ACS) are clinical syndromes caused by the instability or rupture of coronary atheromatous plaques. The development and treatment of ACS are closely related to some ocular manifestations. Hypertensive retinopathy, retinal arteriovenous occlusion, diabetes retinopathy, and age-related macular degeneration are associated with a high risk of ACS. Retinal vascular occlusion may be a potential postoperative complication of the percutaneous coronary intervention for ACS. Ocular parameters such as the retinal vascular diameter and density, the blood flow velocity of the ophthalmic artery, and the choroidal thickness are expected to be markers for assessing or predicting the risk of ACS, which are of important value for the prevention of cardiovascular events such as ACS.

Citation： Cheng Xueru, Wu Lanting, Wang Yanling, Wang Jialin. The research status and progress of ocular manifestations related to acute coronary syndromes. Chinese Journal of Ocular Fundus Diseases, 2023, 39(5): 421-425. doi: 10.3760/cma.j.cn511434-20211215-00702 Copy

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3.	陈旭羚, 杨柳. 高血压视网膜病变与颈动脉病变相关性研究[J]. 中华眼底病杂志, 2016, 32(3): 326-330. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.027.Chen XL, Yang L. Research updates on the correlation of hypertensive retinopathy and carotid artery lesion[J]. Chin J Ocul Fundus Dis, 2016, 32(3): 326-330. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.027.
4.	Arnould L, Guenancia C, Azemar A, et al. The EYE-MI pilot study: a prospective acute coronary syndrome cohort evaluated with retinal optical coherence tomography angiography[J]. Invest Ophthalmol Vis Sci, 2018, 59(10): 4299-4306. DOI: 10.1167/iovs.18-24090.
5.	Hannappe MA, Arnould L, Méloux A, et al. Vascular density with optical coherence tomography angiography and systemic biomarkers in low and high cardiovascular risk patients[J]. Sci Rep, 2020, 10(1): 16718. DOI: 10.1038/s41598-020-73861-z.
6.	Øhrn AM, Schirmer H, von Hanno T, et al. Small and large vessel disease in persons with unrecognized compared to recognized myocardial infarction: the Tromsø study 2007-2008[J]. Int J Cardiol, 2018, 253: 14-19. DOI: 10.1016/j.ijcard.2017.10.009.
7.	Wang JJ, Liew G, Klein R, et al. Retinal vessel diameter and cardiovascular mortality: pooled data analysis from two older populations[J]. Eur Heart J, 2007, 28(16): 1984-1992. DOI: 10.1093/eurheartj/ehm221.
8.	Seidelmann SB, Claggett B, Bravo PE, et al. Retinal vessel calibers in predicting long-term cardiovascular outcomes: the atherosclerosis risk in communities study[J]. Circulation, 2016, 134(18): 1328-1338. DOI: 10.1161/CIRCULATIONAHA.116.023425.
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10.	Dattilo M, Newman NJ, Biousse V. Acute retinal arterial ischemia[J]. Ann Eye Sci, 2018, 3: 28. DOI: 10.21037/aes.2018.05.04.
11.	Mir TA, Arham AZ, Fang W, et al. Acute vascular ischemic events in patients with central retinal artery occlusion in the United States: a nationwide study 2003-2014[J]. Am J Ophthalmol, 2019, 200: 179-186. DOI: 10.1016/j.ajo.2019.01.009.
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13.	Hsieh TC, Chou CL, Chen JS, et al. Risk of mortality and of atherosclerotic events among patients who underwent hemodialysis and subsequently developed retinal vascular occlusion: a Taiwanese retrospective cohort study[J]. JAMA Ophthalmol, 2016, 134(2): 196-203. DOI: 10.1001/jamaophthalmol.2015.5052.
14.	Hu CC, Ho JD, Lin HC. Retinal vein occlusion and the risk of acute myocardial infarction (correction of infraction): a 3-year follow-up study[J]. Br J Ophthalmol, 2009, 93(6): 717-720. DOI: 10.1136/bjo.2008.151605.
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20.	Xie J, Ikram MK, Cotch MF, et al. Association of diabetic macular edema and proliferative diabetic retinopathy with cardiovascular disease: a systematic review and meta-analysis[J]. JAMA Ophthalmol, 2017, 135(6): 586-593. DOI: 10.1001/jamaophthalmol.2017.0988.
21.	Kurihara O, Takano M, Mizuno K, et al. Impact of diabetic retinopathy on vulnerability of atherosclerotic coronary plaque and incidence of acute coronary syndrome[J]. Am J Cardiol, 2016, 118(7): 944-999. DOI: 10.1016/j.amjcard.2016.06.060.
22.	Wu LT, Wang JL, Wang YL. Ophthalmic artery morphological and hemodynamic features in acute coronary syndrome[J]. Invest Ophthalmol Vis Sci, 2021, 62(14): 7. DOI: 10.1167/iovs.62.14.7.
23.	Ahmad M, Kaszubski PA, Cobbs L, et al. Choroidal thickness in patients with coronary artery disease[J/OL]. PLoS One, 2017, 12(6): e0175691[2017-06-20]. https://europepmc.org/abstract/MED/28632734. DOI: 10.1371/journal.pone.0175691.
24.	Kocamaz M, Karadağ O, Onder SE. Comparison of choroidal thicknesses in patients with coronary artery disease and patients at risk of coronary artery disease[J]. Int Ophthalmol, 2021, 41(6): 2117-2124. DOI: 10.1007/s10792-021-01769-2.
25.	Duan Y, Mo J, Klein R, et al. Age-related macular degeneration is associated with incident myocardial infarction among elderly Americans[J]. Ophthalmology, 2007, 114(4): 732-737. DOI: 10.1016/j.ophtha.2006.07.045.
26.	Liutkeviciene R, Lesauskaite V, Zaliuniene D, et al. Early age-related macular degeneration in patients with myocardial infarction[J]. Curr Eye Res, 2012, 37(2): 94-100. DOI: 10.3109/02713683.2011.629069.
27.	张新超, 于学忠, 陈凤英, 等. 急性冠脉综合征急诊快速诊治指南(2019)[J]. 中华急诊医学杂志, 2019, 28(4): 421-428. DOI: 10.3760/cma.j.issn.1671-0282.2019.04.003.Zhang XC, Yu XZ, Chen FY, at al. Guidelines for emergency rapid diagnosis and treatment of acute coronary syndromes (2019)[J]. Chin J Emerg Med, 2019, 28(4): 421-428. DOI: 10.3760/cma.j.issn.1671-0282.2019.04.003.
28.	Kojuri J, Mehdizadeh M, Rostami H, et al. Clinical significance of retinal emboli during diagnostic and therapeutic cardiac catheterization in patients with coronary artery disease[J]. BMC Cardiovasc Disord, 2011, 11: 5. DOI: 10.1186/1471-2261-11-5.
29.	Hsien YM, Mustapha M, Hamzah JC, et al. Why can't I see after my heart is fixed: a case series of ocular complications after cardiac intervention[J]. BMC Ophthalmol, 2016, 16: 32. DOI: 10.1186/s12886-016-0209-1.
30.	La Macchia T, Albiero R, Invernizzi T, et al. Branch retinal artery occlusion after percutaneous coronary intervention[J/OL]. Case Rep Cardiol, 2021, 2021: 9985568[2021-04-27]. https://europepmc.org/article/MED/33996159. DOI: 10.1155/2021/9985568.
31.	Agarwal P, Kumar V, Singh P, et al. Acute macular neuroretinopathy in a patient with acute coronary syndrome[J/OL]. BMJ Case Rep, 2020, 13(12): e238625[2020-12-22]. https://europepmc.org/article/MED/33370997. DOI: 10.1136/bcr-2020-238625.
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40.	Pekel G, Kılıç ID, Alihanoğlu YI, et al. Effects of coronary artery bypass grafting surgery on retinal vascular caliber, ocular pulse amplitude and retinal thickness measurements[J]. Perfusion, 2015, 30(4): 312-317. DOI: 10.1177/0267659114547249.
41.	李悦, 石静, 何美娇. 急性冠状动脉综合征患者抗栓降阶治疗研究进展[J]. 临床心血管病杂志, 2020, 36(12): 1075-1078. DOI: 10.13201/j.issn.1001-1439.2020.12.002.Li Y, Shi J, He MJ. De-escalation of antithrombotic therapy in patients with acute coronary syndrome[J]. Journal of Clinical Cardiology (China), 2020, 36(12): 1075-1078. DOI: 10.13201/j.issn.1001-1439.2020.12.002.
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1. Timmis A. Acute coronary syndromes[J]. BMJ, 2015, 351: h5153. DOI: 10.1136/bmj.h5153.
2. 彭晓燕. 深入认识视网膜血管的特性, 正确处理视网膜血管性疾病[J]. 中华眼底病杂志, 2014, 30(5): 446-449. DOI: 10.3760/cma.j.issn.1005-1015.2014.05.004.Peng XY. Retinal vascular characteristics and the strategy to manage retinal vascular diseases[J]. Chin J Ocul Fundus Dis, 2014, 30(5): 446-449. DOI: 10.3760/cma.j.issn.1005-1015.2014.05.004.
3. 陈旭羚, 杨柳. 高血压视网膜病变与颈动脉病变相关性研究[J]. 中华眼底病杂志, 2016, 32(3): 326-330. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.027.Chen XL, Yang L. Research updates on the correlation of hypertensive retinopathy and carotid artery lesion[J]. Chin J Ocul Fundus Dis, 2016, 32(3): 326-330. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.027.
4. Arnould L, Guenancia C, Azemar A, et al. The EYE-MI pilot study: a prospective acute coronary syndrome cohort evaluated with retinal optical coherence tomography angiography[J]. Invest Ophthalmol Vis Sci, 2018, 59(10): 4299-4306. DOI: 10.1167/iovs.18-24090.
5. Hannappe MA, Arnould L, Méloux A, et al. Vascular density with optical coherence tomography angiography and systemic biomarkers in low and high cardiovascular risk patients[J]. Sci Rep, 2020, 10(1): 16718. DOI: 10.1038/s41598-020-73861-z.
6. Øhrn AM, Schirmer H, von Hanno T, et al. Small and large vessel disease in persons with unrecognized compared to recognized myocardial infarction: the Tromsø study 2007-2008[J]. Int J Cardiol, 2018, 253: 14-19. DOI: 10.1016/j.ijcard.2017.10.009.
7. Wang JJ, Liew G, Klein R, et al. Retinal vessel diameter and cardiovascular mortality: pooled data analysis from two older populations[J]. Eur Heart J, 2007, 28(16): 1984-1992. DOI: 10.1093/eurheartj/ehm221.
8. Seidelmann SB, Claggett B, Bravo PE, et al. Retinal vessel calibers in predicting long-term cardiovascular outcomes: the atherosclerosis risk in communities study[J]. Circulation, 2016, 134(18): 1328-1338. DOI: 10.1161/CIRCULATIONAHA.116.023425.
9. Wang J, Zhao M, Li SJ, et al. Retinal artery lesions and long-term outcome in Chinese patients with acute coronary syndrome[J]. Eye (Lond), 2015, 29(5): 643-648. DOI: 10.1038/eye.2015.2.
10. Dattilo M, Newman NJ, Biousse V. Acute retinal arterial ischemia[J]. Ann Eye Sci, 2018, 3: 28. DOI: 10.21037/aes.2018.05.04.
11. Mir TA, Arham AZ, Fang W, et al. Acute vascular ischemic events in patients with central retinal artery occlusion in the United States: a nationwide study 2003-2014[J]. Am J Ophthalmol, 2019, 200: 179-186. DOI: 10.1016/j.ajo.2019.01.009.
12. Chang YS, Chu CC, Weng SF, et al. The risk of acute coronary syndrome after retinal artery occlusion: a population-based cohort study[J]. Br J Ophthalmol, 2015, 99(2): 227-231. DOI: 10.1136/bjophthalmol-2014-305451.
13. Hsieh TC, Chou CL, Chen JS, et al. Risk of mortality and of atherosclerotic events among patients who underwent hemodialysis and subsequently developed retinal vascular occlusion: a Taiwanese retrospective cohort study[J]. JAMA Ophthalmol, 2016, 134(2): 196-203. DOI: 10.1001/jamaophthalmol.2015.5052.
14. Hu CC, Ho JD, Lin HC. Retinal vein occlusion and the risk of acute myocardial infarction (correction of infraction): a 3-year follow-up study[J]. Br J Ophthalmol, 2009, 93(6): 717-720. DOI: 10.1136/bjo.2008.151605.
15. Werther W, Chu L, Holekamp N, et al. Myocardial infarction and cerebrovascular accident in patients with retinal vein occlusion[J]. Arch Ophthalmol, 2011, 129(3): 326-331. DOI: 10.1001/archophthalmol.2011.2.
16. Rim TH, Han JS, Oh J, et al. Retinal vein occlusion and the risk of acute myocardial infarction development: a 12-year nationwide cohort study[J]. Sci Rep, 2016, 6: 22351. DOI: 10.1038/srep22351.
17. Chen YY, Sheu SJ, Hu HY, et al. Association between retinal vein occlusion and an increased risk of acute myocardial infarction: a nationwide population-based follow-up study[J/OL]. PLoS One, 2017, 12(9): e0184016[2017-09-12]. https://europepmc.org/article/MED/28898259. DOI: 10.1371/journal.pone.0184016.
18. Wu CY, Riangwiwat T, Limpruttidham N, et al. Association of retinal vein occlusion with cardiovascular events and mortality: a systematic review and meta-analysis[J]. Retina, 2019, 39(9): 1635-1645. DOI: 10.1097/IAE.0000000000002472.
19. Nguyen-Khoa BA, Goehring EL, Werther W, et al. Hospitalized cardiovascular events in patients with diabetic macular edema[J]. BMC Ophthalmol, 2012, 12: 11. DOI: 10.1186/1471-2415-12-11.
20. Xie J, Ikram MK, Cotch MF, et al. Association of diabetic macular edema and proliferative diabetic retinopathy with cardiovascular disease: a systematic review and meta-analysis[J]. JAMA Ophthalmol, 2017, 135(6): 586-593. DOI: 10.1001/jamaophthalmol.2017.0988.
21. Kurihara O, Takano M, Mizuno K, et al. Impact of diabetic retinopathy on vulnerability of atherosclerotic coronary plaque and incidence of acute coronary syndrome[J]. Am J Cardiol, 2016, 118(7): 944-999. DOI: 10.1016/j.amjcard.2016.06.060.
22. Wu LT, Wang JL, Wang YL. Ophthalmic artery morphological and hemodynamic features in acute coronary syndrome[J]. Invest Ophthalmol Vis Sci, 2021, 62(14): 7. DOI: 10.1167/iovs.62.14.7.
23. Ahmad M, Kaszubski PA, Cobbs L, et al. Choroidal thickness in patients with coronary artery disease[J/OL]. PLoS One, 2017, 12(6): e0175691[2017-06-20]. https://europepmc.org/abstract/MED/28632734. DOI: 10.1371/journal.pone.0175691.
24. Kocamaz M, Karadağ O, Onder SE. Comparison of choroidal thicknesses in patients with coronary artery disease and patients at risk of coronary artery disease[J]. Int Ophthalmol, 2021, 41(6): 2117-2124. DOI: 10.1007/s10792-021-01769-2.
25. Duan Y, Mo J, Klein R, et al. Age-related macular degeneration is associated with incident myocardial infarction among elderly Americans[J]. Ophthalmology, 2007, 114(4): 732-737. DOI: 10.1016/j.ophtha.2006.07.045.
26. Liutkeviciene R, Lesauskaite V, Zaliuniene D, et al. Early age-related macular degeneration in patients with myocardial infarction[J]. Curr Eye Res, 2012, 37(2): 94-100. DOI: 10.3109/02713683.2011.629069.
27. 张新超, 于学忠, 陈凤英, 等. 急性冠脉综合征急诊快速诊治指南(2019)[J]. 中华急诊医学杂志, 2019, 28(4): 421-428. DOI: 10.3760/cma.j.issn.1671-0282.2019.04.003.Zhang XC, Yu XZ, Chen FY, at al. Guidelines for emergency rapid diagnosis and treatment of acute coronary syndromes (2019)[J]. Chin J Emerg Med, 2019, 28(4): 421-428. DOI: 10.3760/cma.j.issn.1671-0282.2019.04.003.
28. Kojuri J, Mehdizadeh M, Rostami H, et al. Clinical significance of retinal emboli during diagnostic and therapeutic cardiac catheterization in patients with coronary artery disease[J]. BMC Cardiovasc Disord, 2011, 11: 5. DOI: 10.1186/1471-2261-11-5.
29. Hsien YM, Mustapha M, Hamzah JC, et al. Why can't I see after my heart is fixed: a case series of ocular complications after cardiac intervention[J]. BMC Ophthalmol, 2016, 16: 32. DOI: 10.1186/s12886-016-0209-1.
30. La Macchia T, Albiero R, Invernizzi T, et al. Branch retinal artery occlusion after percutaneous coronary intervention[J/OL]. Case Rep Cardiol, 2021, 2021: 9985568[2021-04-27]. https://europepmc.org/article/MED/33996159. DOI: 10.1155/2021/9985568.
31. Agarwal P, Kumar V, Singh P, et al. Acute macular neuroretinopathy in a patient with acute coronary syndrome[J/OL]. BMJ Case Rep, 2020, 13(12): e238625[2020-12-22]. https://europepmc.org/article/MED/33370997. DOI: 10.1136/bcr-2020-238625.
32. Martins DGDS, Rodriguez EEC, Choquechambi YC, et al. Paracentral acute middle maculopathy in patient with atherosclerosis and angioplasty with stents in the coronary artery[J/OL]. Einstein (Sao Paulo), 2021, 19: eRC5521[2021-02-26]. https://europepmc.org/article/MED/33656059. DOI: 10.31744/einstein_journal/2021RC5521.
33. Dinesen S, Jensen PS, Bloksgaard M, et al. Coronary artery bypass surgery independently associates with retinal vascular oxygen saturation[J]. Acta Ophthalmol, 2020, 98(7): 709-715. DOI: 10.1111/aos.14444.
34. Dinesen S, Jensen PS, Bloksgaard M, et al. Retinal vascular fractal dimensions and their association with macrovascular cardiac disease[J]. Ophthalmic Res, 2021, 64(4): 561-566. DOI: 10.1159/000514442.
35. Ciloglu U, Aldag M, Albeyoglu S, et al. Central retinal vein occlusion after coronary artery bypass surgery: a case report[J]. Acta Med Acad, 2017, 46(1): 59-62. DOI: 10.5644/ama2006-124.188.
36. Bahceci Simsek I, Ozay B. Retinal precapillary arteriolar occlusion after coronary artery bypass grafting surgery[J]. Heart Surg Forum, 2016, 19(1): e8-11. DOI: 10.1532/hsf.1347.
37. Farukhi Ahmed S, Tai AX, Schmutz M, et al. Acute onset ocular hypotony after coronary artery bypass surgery[J]. Case Rep Ophthalmol, 2017, 8(1): 200-207. DOI: 10.1159/000468143.
38. Chaturvedi PK, Kumar S, Kumar P, et al. Ocular ischemic syndrome: a rare cause of postoperative visual loss following coronary artery bypass graft (CABG) surgery[J]. Med J Armed Forces India, 2016, 72(Suppl 1): S123-125. DOI: 10.1016/j.mjafi.2015.11.013.
39. Ceruti P, Tosi R, Marchini G. Simultaneous bilateral retinal detachment following coronary artery bypass graft: case report[J]. Eur J Ophthalmol, 2007, 17(5): 860-863. DOI: 10.1177/112067210701700530.
40. Pekel G, Kılıç ID, Alihanoğlu YI, et al. Effects of coronary artery bypass grafting surgery on retinal vascular caliber, ocular pulse amplitude and retinal thickness measurements[J]. Perfusion, 2015, 30(4): 312-317. DOI: 10.1177/0267659114547249.
41. 李悦, 石静, 何美娇. 急性冠状动脉综合征患者抗栓降阶治疗研究进展[J]. 临床心血管病杂志, 2020, 36(12): 1075-1078. DOI: 10.13201/j.issn.1001-1439.2020.12.002.Li Y, Shi J, He MJ. De-escalation of antithrombotic therapy in patients with acute coronary syndrome[J]. Journal of Clinical Cardiology (China), 2020, 36(12): 1075-1078. DOI: 10.13201/j.issn.1001-1439.2020.12.002.
42. Hu DN, Mou CH, Chao SC, et al. Incidence of non-traumatic subconjunctival hemorrhage in a nationwide study in Taiwan from 2000 to 2011[J/OL]. PLoS One, 2015, 10(7): e0132762[2015-07-16]. https://europepmc.org/article/MED/26181776. DOI: 10.1371/journal.pone.0132762.
43. Laurencet ME, Iglesias JF, Noble S, et al. Walking on a thin line between potent platelet inhibition for myocardial infarction and risk of hemorrhagic complications. Tirofiban induced subconjunctival hemorrhage[J]. Cardiol J, 2021, 28(2): 351-352. DOI: 10.5603/CJ.2021.0032.
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