. Author manuscript; available in PMC: 2022 Sep 1.

Published in final edited form as: Am J Med. 2022 Apr 23;135(9):1059–1068. doi: 10.1016/j.amjmed.2022.04.006

Table 3.

Evidence supporting common pathophysiology between MVD of the heart and retina

Reference	Design	Objective	Population	N	Key findings
Akasaka et. Al 1997⁵¹	Cross-sectional	Assess differences in CFR in patients with and without diabetes	CMD	44	CFR was reduced in patients with diabetes and diabetic retinopathy compared to controls. More severe retinopathy was associated with worse coronary flow reserve
Eslami et al 2021⁵³	Descriptive	Describe retinal changes in patients with CMD	CMD	60	Superficial vascular density was abnormal in ~ half of patients with CMD
Sundell et al 2004⁵²	Cross-sectional	Determine whether diabetic retinopathy is associated with reduced coronary vasoreactivity	Diabetic retinopathy	33	Dipyridamole-stimulated flow and coronary vascular resistance were blunted in diabetics with retinopathy compared to diabetics without retinopathy and controls
Liew et al 2019⁵⁶	Cross-sectional	Assess for differences in retinal microvasculature between patients with CMD and CAD	Patients with microvascular angina and CAD	915	Women (but not men) with small retinal venules were three-fold more likely to have microvascular angina compared to women with large retinal venules
Arbel et al 2014⁵⁵	Cross-sectional	Determine utility of retinal blood flow as a predictor of slow coronary artery blood flow	CMD	28	Higher retinal arterial flow was observed in the slow coronary flow group
Wang et al 2008⁵⁴	Cross-sectional	Determine relationship between retinal arteriolar narrowing and myocardial perfusion in patients with and without CAD	Middle and older age adults with no known cardiovascular disease	212	Narrower retinal arterioles are associated with lower hyperemic myocardial perfusion in asymptomatic adults with no coronary calcification
Cheung et al 2007⁵⁷	Cross-sectional	Determine relationship between retinal arteriolar narrowing and left ventricular remodeling in patients with and without CAD	Middle and older age adults with no known cardiovascular disease	4,593	Narrower retinal arterioles are associated with increased left ventricular concentric remodeling regardless of level of coronary atherosclerosis

CAD, coronary artery disease; CFR, coronary flow reserve; CMD, coronary microvascular dysfunction; MVD, microvascular dysfunction.