Quantitative stress perfusion cardiac magnetic resonance (CMR) imaging is an emerging and powerful clinical tool that improves the diagnostic accuracy of stress perfusion CMR for noninvasive assessment of epicardial coronary artery disease, microvascular dysfunction, aortic stenosis, and cardiac allograft vasculopathy.

Rising morbidity and mortality from cardiovascular disease (CVD) have increased interest in precision and preventive management to reduce long-term sequelae. While retinal imaging has traditionally been recognized for identifying vascular changes in systemic conditions such as hypertension and type 2 diabetes mellitus, a new ophthalmologic field, cardiac-oculomics, has associated retinal biomarker changes with other cardiovascular diseases with retinal manifestations. Several imaging modalities visualize the retina, including color fundus photography (CFP), optical coherence tomography (OCT), and OCT angiography (OCTA), which visualize the retinal surface, the individual retinal layers, and the microvasculature within those layers, respectively. In these modalities, imaging-derived biomarkers can present due to CVD and have been linked to the presence, progression, or risk of developing a range of CVD, including hypertension, carotid artery disease, valvular heart disease, cerebral infarction, atrial fibrillation, and heart failure. Promising artificial intelligence (AI) models have been developed to complement existing risk-prediction tools, but standardization and clinical trials are needed for clinical adoption. Beyond risk estimation, there is growing interest in assessing real-time cardiovascular status to track vascular changes following pharmacotherapy, surgery, or acute decompensation. This review offers an up-to-date assessment of the cardiac-oculomics literature and aims to raise awareness among cardiologists and encourage interdepartmental collaboration.

Background: Central retinal artery occlusion (CRAO) is an ophthalmic condition associated with cerebrovascular ischaemia. In patients with acute CRAO, the 2021 American Heart Association (AHA) scientific statement recommends a diagnostic evaluation for secondary stroke prevention, including cerebrovascular imaging, cardiac rhythm monitoring, echocardiogram and labs. This study aims to understand the national stroke evaluation rates for patients with CRAO before 2021. Methods: Retrospective, cross-sectional analysis of inpatient admissions from the National Inpatient Sample between 2016 and 2021. Echocardiogram, head and neck vessel imaging and temporal artery biopsy completion during hospital admissions with a principal diagnosis of CRAO were measured. Clustering analysis was performed to characterise differences in stroke evaluations. Results: 9615 inpatient stays for CRAO were identified. Only 0.3% underwent carotid ultrasounds, 10% underwent echocardiograms, and 8.5% underwent cerebrovascular imaging. Echocardiograms (10%) were most frequently performed, followed by temporal artery biopsy (6.4%). Clustering analysis reveals a cluster of older females on non-Health Maintenance Organisation Medicare receiving temporal artery biopsies. Other clusters consisted of younger males, who were more likely to receive an echocardiogram or cerebrovascular imaging and be discharged home. Independent predictors increasing the odds of undergoing stroke evaluations include female sex, transfer from another facility, residence in zip codes with a median household income of >$79 000, concurrent diagnosis of cerebral stroke, carotid atherosclerosis and nicotine dependence through cigarette use. Conclusions: In this national cohort study, low percentages of patients with CRAO were evaluated for secondary stroke prevention before the 2021 AHA scientific statement on CRAO management. Notably, higher socioeconomic status patients underwent more comprehensive stroke evaluations.