Last Friday I saw a new patient whose dilated fundus exam showed tortuous blood vessels. I told her this could be associated with high blood pressure, but she said her blood pressure was normal. And then a couple days later, I read an article regarding retinal vessel tortuosity, and it said that it can be related to several cardiovascular diseases. In addition to high blood pressure, it is related to instances of angina, myocardial infarction, stroke, and deep vein thrombosis. There was a study performed in Switzerland that mapped the genetic components of various diseases with retinal vessel tortuosity. So if I tell you that you have tortuous blood vessels or you see them on fundus photos when we review them in the exam room, I suggest you see your physician for a work up of cardiovascular diseases. Below is the reference for this article.
Tomasoni M. Beyeler MJ, Vea SO, et al. Genome-Wide Association Studies of retinal vessel tortuosity identify numerous novel loci revealing genes and pathways associated with ocular and cardiometabolic diseases. Ophthalmol Sci. February 16, 2023 (Epub ahead of print).
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