The prevalence and severity of retinopathy in patients with coronary artery disease at a tertiary hospital in Durban, South Africa.

Abstract

Background Studies have described the prognostic value of retinopathy in coronary artery disease (CAD), but few have examined the relationship between retinopathy and CAD severity. Aim The study investigated the prevalence of retinopathy in CAD patients [acute coronary syndrome (ACS) and chronic stable CAD] and determined the association of retinopathy and other clinical factors with the extent of coronary artery disease as assessed by the number of epicardial vessels involved. Methods A cross-sectional prospective study of 121 in-patients was undertaken over a ten-month period at Inkosi Albert Luthuli Central Hospital. One hundred and nine patients (12 stable CAD, 97 acute coronary syndromes) had angiographically confirmed CAD, and the remaining 12 patients with normal angiograms served as controls. All participants had a comprehensive systemic evaluation and fasting biochemistry. Retinopathy was assessed using five to seven wide-field fundus photographs. Macular thickness, vessel density and macular perfusion were assessed with optical coherence tomography (OCT) and OCT angiography. Results Compared to subjects with normal angiograms (controls), those with CAD had more frequent diabetes (67.9% vs 16.7%, p<0.001). Triple vessel disease (TVD) was present in 43.4% of diabetic patients compared to 35.6% of non-diabetics (p=0.004). Multivessel involvement was more frequent in diabetics (79%) compared to nondiabetics (58%) (p=0.002).