# Use of retinal ischemic perivascular lesions (RIPLS) as a biomarker for cardiovascular disease – a systematic review and meta-analysis

## TL;DR

This study finds that retinal ischemic perivascular lesions detected with OCT are linked to a higher risk of cardiovascular disease, suggesting they could be a useful early screening biomarker.

## Contribution

The study is the first to systematically review and meta-analyze the association between RIPLs and cardiovascular disease risk using OCT.

## Key findings

- RIPLs detected by OCT are associated with a more than twofold increased risk of cardiovascular disease.
- The pooled odds ratio for cardiovascular morbidity linked to RIPLs was 2.8 (95% CI: 1.98–3.95).
- Minimal heterogeneity was observed across the included studies.

## Abstract

This study aims to evaluate the association between retinal ischemic perivascular lesions (RIPLs) detected by optical coherence tomography (OCT) and the risk of all-cause cardiovascular morbidity.

A systematic review and meta-analysis were performed. PubMed MEDLINE, Scopus, and Cochrane CENTRAL were searched for observational studies from January 2015 to March 2025 assessing RIPLs and cardiovascular disease (CVD). Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model.

Of 61 studies screened, six met inclusion criteria and four were included in the meta-analysis (total n = 710). The pooled OR for CVD morbidity associated with RIPLs was 2.8 (95% CI: 1.98–3.95), indicating over a twofold increased risk. Heterogeneity was minimal (I² = 0%).

RIPLs detected by OCT are significantly associated with increased cardiovascular risk. Due to OCT’s non-invasive and accessible nature, RIPLs may be a useful screening biomarker for early detection of CVD.

The online version contains supplementary material available at 10.1186/s40942-025-00782-2.