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Advances in Cardiovascular Imaging

Retinal Vascular Imaging

A New Tool in Microvascular Disease Research

Gerald Liew, MD, MMed; Jie Jin Wang, MMed, PhD; Paul Mitchell, MD, PhD and Tien Y. Wong, MD, PhD

From the Centre for Vision Research (G.L., J.J.W., P.M., T.Y.W.), University of Sydney, Australia; Centre for Eye Research Australia (J.J.W., T.Y.W.), University of Melbourne, Australia, and Singapore Eye Research Institute; Yong Loo Lin School of Medicine Westmead Millennium Institute, National University of Singapore, Singapore.

Correspondence to Jie Jin Wang, MMed, PhD, Centre for Vision Research, Department of Ophthalmology, University of Sydney, Westmead Hospital, Hawkesbury Rd, Westmead, NSW 2145, Australia. E-mail jiejin_wang{at}wmi.usyd.edu.au

Received April 8, 2008; accepted July 14, 2008.

The microcirculation is relatively inaccessible to direct visualization and investigation. Recent methods have been developed which use advanced retinal photographic imaging techniques and computer-assisted image analysis to characterize, measure and quantify subtle variations and abnormalities in the retinal vasculature. These quantitative and qualitative assessments demonstrate a close association of retinal vascular signs to both clinical and subclinical cerebrovascular, cardiovascular and metabolic outcomes. Retinal vascular imaging may thus offer potential as a noninvasive research tool to probe the role and pathophysiology of the microvasculature, and as a cardiovascular risk prediction tool. Key areas where retinal vascular imaging has contributed to increased understanding of microvascular pathology and major areas of current and new research are discussed in this review.

Key Words: arteriosclerosis • microcirculation • retinal vessels • cardiovascular disease • risk factors

The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.