Retinal and coronary imaging in type 1 diabetes: links between retinopathy and subclinical cardiovascular disease.
- 13rd Department of Internal Medicine - Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic.
Abstract
Cardiovascular disease (CVD) remains the leading cause of premature morbidity and mortality in individuals with type 1 diabetes mellitus (T1DM), despite advances in glycemic management and cardiovascular prevention. Conventional cardiovascular risk assessment may underestimate risk in T1DM, particularly among younger asymptomatic individuals, highlighting the need for markers of early vascular injury. Diabetic retinopathy (DR), a microvascular complication of T1DM, is increasingly recognized as a marker of systemic vascular dysfunction rather than an isolated ocular disorder. Non-invasive retinal visualization may provide insight into vascular and atherosclerotic disease. This mini-review summarizes evidence linking DR with subclinical coronary artery disease (CAD) and cardiovascular outcomes in T1DM, focusing on coronary artery calcium (CAC) and coronary computed tomography angiography (CCTA). Observational and longitudinal studies consistently link DR severity with CAC burden, coronary plaque burden, silent CAD, and cardiovascular outcomes, independent of traditional risk factors. Albuminuria and diabetic kidney disease may provide complementary evidence of a broader microvascular phenotype associated with cardiovascular risk. Advances in retinal imaging, including optical coherence tomography angiography and artificial intelligence-based oculomics, support the role of retinal biomarkers in cardiovascular risk prediction. CAC scoring remains valuable for detecting subclinical coronary atherosclerosis, while CCTA characterizes calcified and non-calcified plaque. Emerging evidence suggests that integrating retinal and microvascular markers with coronary imaging may improve identification of asymptomatic individuals at increased cardiovascular risk and support intervention. Although data are observational and prospective validation is required, multimodal strategies combining clinical risk factors, retinal biomarkers, albuminuria, CAC, and CCTA may enhance cardiovascular risk stratification in T1DM.
Related
- Diabetic retinopathy enhances coronary artery calcium-based cardiovascular risk stratification in patients with type 2 diabetes: insights from the ACCoDiab study.
- Prior Cardiovascular Disease and Incident Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetes Mellitus
- Lipoprotein(a), smoking, and diabetes are additive but not interactive risk factors for major adverse cardiovascular events after acute coronary syndrome
- Cardiovascular preventive role of thiazolidinedione in patients with type 2 diabetes mellitus undergoing percutaneous coronary intervention
- Associations between cardiac adipose tissue volume, measures of coronary calcification, myocardial microvascular function and systemic inflammation in individuals with type 2 diabetes free of overt cardiovascular disease.
BibTeX
@article{lyskova2026retinal,
title = {{Retinal and coronary imaging in type 1 diabetes: links between retinopathy and subclinical cardiovascular disease.}},
author = {Lucie Lyskova and David Karasek},
journal = {Frontiers in cardiovascular medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1963643},
url = {https://europepmc.org/article/MED/42909265},
note = {CC BY},
}
RIS
TY - JOUR
TI - Retinal and coronary imaging in type 1 diabetes: links between retinopathy and subclinical cardiovascular disease.
AU - Lucie Lyskova
AU - David Karasek
PY - 2026
DA - 2026/10/07
JO - Frontiers in cardiovascular medicine
DO - 10.3389/fcvm.2026.1963643
UR - https://europepmc.org/article/MED/42909265
AB - Cardiovascular disease (CVD) remains the leading cause of premature morbidity and mortality in individuals with type 1 diabetes mellitus (T1DM), despite advances in glycemic management and cardiovascular prevention. Conventional cardiovascular risk assessment may underestimate risk in T1DM, particularly among younger asymptomatic individuals, highlighting the need for markers of early vascular injury. Diabetic retinopathy (DR), a microvascular complication of T1DM, is increasingly recognized as a marker of systemic vascular dysfunction rather than an isolated ocular disorder. Non-invasive retinal visualization may provide insight into vascular and atherosclerotic disease. This mini-review summarizes evidence linking DR with subclinical coronary artery disease (CAD) and cardiovascular outcomes in T1DM, focusing on coronary artery calcium (CAC) and coronary computed tomography angiography (CCTA). Observational and longitudinal studies consistently link DR severity with CAC burden, coronary plaque burden, silent CAD, and cardiovascular outcomes, independent of traditional risk factors. Albuminuria and diabetic kidney disease may provide complementary evidence of a broader microvascular phenotype associated with cardiovascular risk. Advances in retinal imaging, including optical coherence tomography angiography and artificial intelligence-based oculomics, support the role of retinal biomarkers in cardiovascular risk prediction. CAC scoring remains valuable for detecting subclinical coronary atherosclerosis, while CCTA characterizes calcified and non-calcified plaque. Emerging evidence suggests that integrating retinal and microvascular markers with coronary imaging may improve identification of asymptomatic individuals at increased cardiovascular risk and support intervention. Although data are observational and prospective validation is required, multimodal strategies combining clinical risk factors, retinal biomarkers, albuminuria, CAC, and CCTA may enhance cardiovascular risk stratification in T1DM.
SN - 2297-055X
ER -