Conjunctival microvascular alteration in patients with coronary artery disease assessed using optical coherence tomographic angiography

Background: To quantify conjunctival microvascular characteristics obtained by optical coherence tomographic angiography (OCTA) and investigate their relationship with the presence and severity of coronary artery disease (CAD). Methods: This cross-sectional study included 103 consecutive CAD patients confirmed by coronary angiography and 125 non-CAD controls. The temporal conjunctivas along the limbus of each participant were scanned using OCTA. Quantification of conjunctival microvasculature was performed by AngioTool software. The severity of the disease was evaluated using SYNTAX and Gensini scores. Results: Compared to the controls, the CAD group exhibited significantly lower vessel area density (30.22 f 3.34 vs. 26.70 f 4.43 %, p < 0.001), lower vessel length density (6.39 f 0.77 vs. 5.71 f 0.89/m, p < 0.001), lower junction density (3.44 f 0.56 vs. 3.05 f 0.63/m, p < 0.001), and higher lacunarity (0.11 f 0.03 vs. 0.14 f 0.05, p < 0.001). Among all participants, lower vessel area density, lower vessel length density, lower junction density, and higher lacunarity were associated with greater odds of having CAD; the adjusted ORs (95 % confidence intervals) per one SD decrease were 2.71 (1.71, 4.29), 2.51(1.61, 3.90), 2.06 (1.39, 3.05), and 0.36 (0.23, 0.58), respectively. Among CAD patients, junction density was negatively associated with the Gensini score (r = -0.359, p = 0.037) and the Syntax score (r = -0.350, p = 0.042) in women but not in men (p > 0.05). Conclusions: Conjunctival microvascular characteristics were significantly associated with the presence of CAD. Junction density significantly associated with the severity of CAD among women patients.