The Ophthalmic Manifestations of Systemic Vascular Diseases: A Literature Review

• DOI: https://doi.org/10.22533/at.ed.1595322522104

• Palavras-chave: Manifestações oftálmicas; doenças vasculares sistêmicas; microangiopatia retiniana; angiografia por tomografia de coerência óptica; oculômica.

• Keywords: Ophthalmic manifestations; systemic vascular disease; retinal microangiopathy; optical coherence tomography angiography; oculomics.

• Abstract: Abstract Background: Systemic vascular diseases exert profound effects on the ocular circulation, reflecting the shared architecture of endothelial, neural, and metabolic regulation that connects the eye to the rest of the body. Retinal and choroidal microvasculature offer a unique opportunity to observe systemic pathophysiology in vivo, transforming ophthalmology into a window for vascular medicine. Objective: To synthesize the current literature on the ophthalmic manifestations of systemic vascular diseases, emphasizing pathophysiologic mechanisms, diagnostic technologies, and the prognostic value of ocular findings in systemic health. Methods: A narrative review was conducted using PubMed, Scopus, Embase, and Web of Science databases. Seventeen peer-reviewed articles published between 2012 and 2025 were selected for relevance, originality, and accessibility. The review integrates studies addressing hypertensive and atherosclerotic retinopathy, diabetic microangiopathy, autoimmune vasculopathies, ocular ischemic syndrome, and emerging imaging-based biomarkers. Results: Hypertension and atherosclerosis produce progressive arteriolar narrowing, endothelial dysfunction, and retinal ischemia, while diabetes induces pericyte loss, basement-membrane thickening, and neuroinflammation. Autoimmune disorders such as systemic lupus erythematosus and Behçet’s disease provoke immune-complex vasculitis and ischemic occlusion. Ocular ischemic syndrome mirrors advanced carotid atherosclerosis and carries high cerebrovascular risk. Novel imaging tools—especially OCT-angiography, adaptive optics, and AI-based retinal analytics—allow quantification of subclinical microvascular changes and prediction of systemic outcomes. Conclusion: The ocular circulation functions as a dynamic biomarker of systemic vascular health. By uniting clinical observation, advanced imaging, and computational analysis, modern ophthalmology provides unprecedented insight into systemic microvascular pathology. Integrating ocular biomarkers into cardiovascular and metabolic risk assessment may transform early diagnosis and personalized prevention strategies across medicine.