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Eric L. Michelson, MD; Joel Morganroth, MD; Charles W. Nichols, MD; Horace MacVaugh III, MD

Arch Intern Med. 1979;139(10):1139-1141.

Abstract
Funduscopic examination was performed in 70 nondiabetic, nonhypertensive patients without valvular heart disease undergoing coronary angiography for evaluation of chest pain syndromes to determine if retinal arteriolar changes could reliably predict presence of coronary artery disease. Retinal arteriolar changes were graded with respect to light reflex, vessel caliber, arteriovenous crossing defects, and vessel tortuosity without knowledge of angiographic findings. Each coronary vessel was graded with respect to its most occlusive lesion by angiography; coronary index was derived for each patient without knowledge of eye findings. Abnormal light reflex changes were the most sensitive indicators of presence and extent of coronary artery disease. Abnormal vessel tortuosity and decreased caliber were less sensitive but more specific; their presence also suggested more extensive coronary lesions. Thus, funduscopic examination demonstrating specific retinal arteriolar lesions may indicate presence of coronary artery disease and may correlate with extent of lesions in selected patients.

(Arch Intern Med 139:1139-1141, 1979)

Author Affiliations
From the Cardiovascular Section, Department of Medicine (Drs Michelson, and Morganroth), Department of Ophthalmology (Dr Nichols) and the Cardiothoracic Surgery Section (Dr MacVaugh), Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia.

Footnotes
Accepted for publication May 7, 1979.

Reprint requests to Lankenau Hospital, 2221 Medical Science Bldg, City Line and Lancaster Avenues, Philadelphia, PA 19151 (Dr Morganroth).

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