6533b85efe1ef96bd12bf9c7

RESEARCH PRODUCT

Retinal vascular network: description in elderly and pathological process

subject

description

For more than 10 years, description of the retinal microvascular network has benefited from the development of new imaging techniques. Automatic retinal images analysis software, as well as OCT angiography, are able to highlight subtle and early changes in the retinal vascular network. In addition, these software allow to obtain a large amount of quantitative microvascular parameters which improve the characterization of retinal vascularization. The challenge of current research is to demonstrate the association between these microvascular modifications, systemic vascular aging process and cerebral and cardiovascular disease. Indeed, a physiopathological continuum exists between retinal microvascular modification and vascular systemic diseases. In the Montrachet population-based study, we demonstrated that a suboptimal retinal vascular network evaluated with the SIVA software (decrease of the retinal fractal dimension and heterogeneity of the vascular lumen) was significantly associated with a treated diabetes and an increased risk of cardiovascular mortality. In addition, we completed our research on the retinal vascular network with the use of OCT-angiography (OCT-A). In the EYE-MI study, we demonstrated the potential interest of quantitative characterization of the retinal microvascular network with OCT-A in order to assess the cardiovascular risk profile of patients with history of myocardial infarction. A high AHA risk score was associated with low retinal vascular density independently of hemodynamic changes. Thus, a better understanding of the association between retinal microvascularization and macrovascular disease would make it possible to implement more stringent control of cardiovascular risk factors within the framework of personalized and early primary prevention. The retinal vascular network could therefore be a witness of systemic vascular history but also an interesting predictive biomarker of systemic vascular events.