Current approaches to retinopathy as a predictor of cardiovascular risk

Abstract

Current guidelines emphasize the need for regular eye screening to detect retinopathy signs in patients with diabetes. This presents clinicians with a unique opportunity to visualize, assess and monitor the direct effects of diabetes and hyperglycemia on the microcirculation. Although the adverse impact of diabetic retinopathy on vision is well known, its clinical significance beyond the eye is less well recognized. Recent studies show that patients with diabetic retinopathy are more likely to have subclinical cardiovascular disease, and the presence of retinopathy signs is associated with increased risk of clinical stroke, coronary heart disease, heart failure and mortality. There is also emerging evidence to suggest that diabetic retinopathy may share common genetic linkages with many vascular diseases. These new data support the theory that retinopathy signs may reflect widespread microcirculatory disease not only in the eye but also in vital organs elsewhere in the body. Being a specific and noninvasive measure of diabetic microvascular damage, retinopathy signs may therefore also have a role in improving cardiovascular risk prediction in patients with diabetes. © 2010 S. Karger AG, Basel.