Are the Eyes a Window to the Heart?

By Dr. Cheryl G. Murphy, OD

Optical Coherence Tomography (OCT) is a non-invasive, diagnostic test in many optometrists’ offices, and it gives them a detailed look at different layers of cells inside the eye. A new study suggests that having OCT performed may help catch not only problems with the eyes but also with the heart.

Retinal Ischemic Perivascular Lesions (RIPLs) are permanent marks left on the retina due to ischemia or lack of blood flow to the retina. When the retina receives less blood then it expects, it also receives less oxygen and that can damage retinal tissue over time. In March 2021, Long et al published a study in which they suggest RIPLs can be a biomarker for cardiovascular disease. They “reviewed the records of individuals who received a retinal OCT scan at UC San Diego Health from July 2014 to July 2019. From that cohort, two groups were identified after medical chart review: one consisted of 84 individuals with heart disease and the other included 76 healthy individuals as the study’s control group. An increased number of RIPLs was observed in the eyes of individuals with heart disease and according to the researchers, the higher the number of RIPLs in the eye, the higher the risk for cardiovascular disease.”

Any method that healthcare professionals can use to detect heart disease earlier is valuable since “about 655,000 Americans die from heart disease each year- that’s 1 in every 4 deaths.”

The CDC says that heart disease is the “leading cause of death for men, women and people of most racial and ethnic groups” in the United States and that “1 person dies every 36 seconds in the US from cardiovascular disease.” Risk factors include high blood pressure, smoking and high cholesterol. People who are obese, have an unhealthy diet, are diabetic, don’t get enough exercise and those who drink alcohol excessively are also at higher risk for cardiovascular complications.

While optometrists can perform careful evaluation of the retina for RIPLs through OCT testing, checking the eye for warning signs of changes in vascular health is nothing new. Optometrists and ophthalmologists have been using other methods to directly examine retinal blood vessels for vascular changes such as slit lamp biomicroscopy, binocular indirect ophthalmoscopy and retinal photography for decades. “The retina is a unique site where the microcirculation can be imaged directly. Thus, it provides a window for detecting changes in microvasculature relating to the development of cardiovascular diseases such as arterial hypertension or coronary heart disease.”

Some researchers have said that since the blood vessels inside the eye are so similar in structure to those of the heart and are so easily accessible that the eyes can be a window to one’s heart health. The vasculature of the eye and the heart share several common characteristics. There is interplay between cardiovascular functions and risk factors and the occurrence and progression of many eye diseases. In particular, arteriovenous nipping, narrowing of retinal arteries, and the dilation of retinal veins are important signs of increased cardiovascular risk.”

Getting an annual eye exam as well as any additional diagnostic testing the eye doctor may suggest are crucial steps in keeping one’s eye health and heart health at their best.

Photo credit- Robin Weermeijer- Unsplashed

 

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