• Vol. 36 No. 10, S4–S8
  • 15 October 2007

Retinal and Cardiovascular Diseases: The “Common Soil” Theory



Retinal and cardiovascular diseases share many risk factors, such as hypertension, hyperlipidaemia and cigarette smoking. The effects of hypertension and diabetes on the retina are well known. In response to elevated blood pressure, the retinal vasculature undergoes a series of changes clinically seen as hypertensive retinopathy. Patients with hypertensive retinopathy signs are more likely to develop stroke, ischaemic heart disease, heart failure and to die from these conditions. In persons with diabetes, retinopathy is a common microvascular complication and the leading cause of blindness in working adults. Hyperglycaemia, hypertension and hyperlipidaemia are risk factors for the development and progression of diabetic retinopathy, and the presence of even early signs of retinopathy is associated with increased cardiovascular morbidity in persons with diabetes. Various cardiovascular diseases have also been associated with the development of other retinal conditions, including retinal vein occlusions, retinal arteriolar emboli and age-related macular degeneration. Ophthalmologists and physicians should therefore recognise the protean effects of cardiovascular diseases on the retina to better manage their patients.

There is increasing evidence that retinal and cardiovascular diseases share a “common soil”. Risk factors for cardiovascular disease, such as hypertension, diabetes, hyperlipidaemia and cigarette smoking, are known to influence the development of a range of retinal diseases, including hypertensive retinopathy, diabetic retinopathy, retinal vein and artery occlusion, retinal arteriolar emboli and age-related macular degeneration (AMD). Concurrently, many of these retinal conditions may be “markers” of underlying subclinical vascular disease and predict the future development of cardiovascular events and mortality. Understanding the inter-relationship between retinal and the cardiovascular diseases will allow both researchers and clinicians to design new preventative strategies and therapies, and to better manage patients with these conditions. This review summarises recent findings on the relationship of cardiovascular disease and common retinal conditions.

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