Arteriosclerotic Retinopathy

Complex MONDO:0042495 Pathograph 5 Arteriosclerosis disorder Retinal vascular disorder

Arteriosclerotic retinopathy is a chronic retinal vascular disorder marked by arteriosclerotic change in retinal arterioles. In clinical and epidemiologic studies it overlaps with "retinal arteriosclerosis" or "fundus arteriosclerosis" and is commonly operationalized with Scheie atherosclerotic grades or related fundus-photographic grading systems. The disorder is primarily an ocular manifestation and biomarker of systemic vascular disease, including arterial stiffness, carotid atherosclerosis, and cardiovascular risk.

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2
Pathophys.
4
Phenotypes
5
Pathograph
1
Treatments
12
References
1
Deep Research
⚙

Pathophysiology

2
Retinal arteriolar sclerosis
The central disease process is sclerosis and remodeling of retinal arterioles, visible as Scheie-defined atherosclerotic retinal changes and related fundus arteriosclerosis signs.
retinal blood vessel endothelial cell link smooth muscle cell link
blood vessel remodeling link ⚠ ABNORMAL endothelial cell proliferation link ↑ INCREASED
retina link arteriole link
Downstream
Retinopathy Retinal arteriolar remodeling contributes to clinically visible retinopathy.
Show evidence (2 references)
PMID:33239480 SUPPORT Human Clinical
"retinopathy based on Scheie classification are often applied to evaluate the impact of hypertension and atherosclerosis."
This supports Scheie-classified atherosclerotic retinopathy as the clinical retinal arteriolar sclerosis phenotype.
PMID:26133318 SUPPORT Human Clinical
"Significant correlations were found between the presence of arteriosclerotic retinopathy"
This hemodialysis cohort directly studied arteriosclerotic retinopathy graded by Scheie S grade.
Systemic vascular stiffness and atherosclerosis association
Arteriosclerotic retinal findings track with systemic vascular stiffness and macrovascular atherosclerotic burden, supporting the use of retinal vascular imaging as a noninvasive systemic vascular biomarker.
blood vessel remodeling link ⚠ ABNORMAL
retina link
Downstream
Cardiovascular disease risk stratification Retinal microvascular findings can contribute to systemic vascular risk assessment.
Show evidence (2 references)
PMID:33239480 SUPPORT Human Clinical
"atherosclerotic retinopathy was significantly associated with CAVI and carotid IMT."
The study links Scheie-defined atherosclerotic retinal lesions with functional and morphologic large-artery atherosclerosis measures.
PMID:37968750 SUPPORT Human Clinical
"fundus arteriosclerosis was significantly associated with the risk of carotid atherosclerosis."
The large health-examination cohort supports a clinically relevant fundus-arteriosclerosis association with carotid atherosclerosis.
⬡

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Referential integrity issues (1):
  • Target 'Cardiovascular disease risk stratification' (from 'Systemic vascular stiffness and atherosclerosis association') not found in named elements
Pathograph: causal mechanism network for Arteriosclerotic Retinopathy Interactive directed graph showing how pathophysiology mechanisms, phenotypes, genetic factors and variants, experimental models, environmental triggers, and treatments relate through causal and linked edges.
●

Phenotypes

4
Eye 1
Retinopathy Retinopathy (HP:0000488)
Show evidence (1 reference)
PMID:33239480 SUPPORT Human Clinical
"The absence or presence and extent of retinopathy were characterized by ophthalmologists"
The study operationalized both hypertensive and atherosclerotic retinal lesions as retinopathy grades.
Other 3
Retinal arteriolar narrowing Attenuation of retinal blood vessels (HP:0007843)
Show evidence (1 reference)
PMID:38793083 PARTIAL Human Clinical
"A narrower CRAE, wider CRVE and a lower AVR have been associated with increased cardiovascular events."
CRAE is an arteriolar-caliber metric; the review supports narrowed retinal arterioles as a vascular-risk imaging feature, although not specific to Scheie-defined arteriosclerotic retinopathy.
Enhanced retinal arteriolar light reflex
Show evidence (1 reference)
PMID:17070582 SUPPORT Human Clinical
"The enhanced arteriolar light reflex sign was found in 1053 participants (31.7%"
This population study supports enhanced arteriolar light reflex as a common retinal arteriolar wall sign.
Arteriovenous nicking
Show evidence (1 reference)
PMID:17070582 SUPPORT Human Clinical
"arteriovenous nicking (OR 3.12) or retinopathy (OR 1.96)."
The study shows that enhanced arteriolar light reflex is strongly associated with arteriovenous nicking and retinopathy.
💊

Treatments

1
Cardiovascular risk-factor management and retinal surveillance
No disease-specific ocular pharmacotherapy was identified in the Falcon report. Practical management is prevention-oriented: identify and treat systemic vascular risk factors and monitor retinal vascular signs over time.
Mechanism Target:
MODULATES Systemic vascular stiffness and atherosclerosis association — Risk-factor control targets the systemic vascular disease context that is associated with retinal arteriosclerosis rather than reversing established retinal arteriolar sclerosis directly.
Show evidence (1 reference)
PMID:33239480 PARTIAL Human Clinical
"CAVI and carotid IMT are independent determinants of retinopathy."
This supports targeting systemic arterial stiffness and atherosclerosis risk as a management rationale, while not proving direct treatment reversal of retinal lesions.
Show evidence (2 references)
PMID:33239480 PARTIAL Human Clinical
"CAVI and carotid IMT are independent determinants of retinopathy."
This supports a systemic vascular-risk management rationale, although it is observational rather than an intervention trial.
PMID:38793083 PARTIAL Human Clinical
"Retinal vascular imaging using AI may help identify the cardiovascular risk"
This supports retinal vascular imaging as a prevention and surveillance tool for cardiovascular risk.
🌍

Environmental Factors

5
Hypertension
Hypertension is a major systemic vascular context in which Scheie retinopathy grading is applied and atherosclerotic retinal lesions are evaluated.
Show evidence (1 reference)
PMID:33239480 SUPPORT Human Clinical
"evaluate the impact of hypertension and atherosclerosis."
The study explicitly frames Scheie retinopathy grading as a way to evaluate hypertension and atherosclerosis effects in the ocular fundus.
Heavy alcohol consumption
Heavy alcohol consumption was associated with marked enhanced retinal arteriolar light reflex in the Blue Mountains Eye Study cohort.
Show evidence (1 reference)
PMID:17070582 SUPPORT Human Clinical
"Markedly enhanced light reflex was significantly associated with mean arterial blood pressure (OR 1.24), heavy alcohol consumption (OR 2.66, > or = 40 grams alcohol per day), and serum glucose (OR 1.16)."
This directly supports heavy alcohol consumption as a systemic risk factor associated with marked enhanced retinal arteriolar light reflex.
Dyslipidemia
Lipid abnormalities, including higher total cholesterol, LDL cholesterol, and triglycerides, were associated with enhanced retinal arteriolar light reflex.
Show evidence (1 reference)
PMID:17070582 SUPPORT Human Clinical
"mildly enhanced light reflex was significantly associated with serum glucose (OR 1.11 per SD increase), total cholesterol (OR 1.11), low-density lipoprotein (OR 1.55), triglycerides (OR 1.11)"
This supports dyslipidemia-related measures as risk correlates of enhanced retinal arteriolar light reflex.
Serum glucose dysregulation
Higher serum glucose was associated with both mild and marked enhanced retinal arteriolar light reflex, consistent with a metabolic vascular-risk context.
Show evidence (2 references)
PMID:17070582 SUPPORT Human Clinical
"serum glucose (OR 1.11 per SD increase)"
This supports serum glucose as a metabolic factor associated with mildly enhanced retinal arteriolar light reflex.
PMID:17070582 SUPPORT Human Clinical
"serum glucose (OR 1.16)."
This supports serum glucose as a metabolic factor associated with markedly enhanced retinal arteriolar light reflex.
Chronic kidney disease on hemodialysis
Chronic kidney disease requiring hemodialysis is a clinical context in which retinal arterial sclerosis has been associated with arterial stiffness and prior cardiovascular disease.
Show evidence (1 reference)
PMID:26133318 SUPPORT Human Clinical
"Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) have a high prevalence of cardiovascular diseases"
The study directly examined retinal arterial sclerosis in a CKD hemodialysis cohort with high cardiovascular disease burden.
🔬

Biochemical Markers

1
Serum uric acid trajectory (Higher trajectory)
Show evidence (1 reference)
PMID:36926048 SUPPORT Human Clinical
"Higher SUA trajectory groups were significantly associated with an increased risk of incident retinal arteriosclerosis in men"
This longitudinal cohort supports higher serum uric acid trajectories as a male-specific risk marker for incident retinal arteriosclerosis.
{ }

Source YAML

click to show 
name: Arteriosclerotic Retinopathy
creation_date: "2026-05-06T17:24:49Z"
updated_date: "2026-05-06T17:54:50Z"
description: >-
  Arteriosclerotic retinopathy is a chronic retinal vascular disorder marked by
  arteriosclerotic change in retinal arterioles. In clinical and epidemiologic
  studies it overlaps with "retinal arteriosclerosis" or "fundus
  arteriosclerosis" and is commonly operationalized with Scheie atherosclerotic
  grades or related fundus-photographic grading systems. The disorder is
  primarily an ocular manifestation and biomarker of systemic vascular disease,
  including arterial stiffness, carotid atherosclerosis, and cardiovascular risk.
category: Complex
disease_term:
  preferred_term: arteriosclerotic retinopathy
  term:
    id: MONDO:0042495
    label: arteriosclerotic retinopathy
synonyms:
- retinal arteriosclerosis
- arteriosclerosis disorder of retina
- retinopathy, arteriosclerotic
parents:
- Arteriosclerosis disorder
- Retinal vascular disorder
pathophysiology:
- name: Retinal arteriolar sclerosis
  description: >-
    The central disease process is sclerosis and remodeling of retinal
    arterioles, visible as Scheie-defined atherosclerotic retinal changes and
    related fundus arteriosclerosis signs.
  locations:
  - preferred_term: retina
    term:
      id: UBERON:0000966
      label: retina
  - preferred_term: arteriole
    term:
      id: UBERON:0001980
      label: arteriole
  cell_types:
  - preferred_term: retinal blood vessel endothelial cell
    term:
      id: CL:0002585
      label: retinal blood vessel endothelial cell
  - preferred_term: smooth muscle cell
    term:
      id: CL:0000192
      label: smooth muscle cell
  biological_processes:
  - preferred_term: blood vessel remodeling
    modifier: ABNORMAL
    term:
      id: GO:0001974
      label: blood vessel remodeling
  - preferred_term: endothelial cell proliferation
    modifier: INCREASED
    term:
      id: GO:0001935
      label: endothelial cell proliferation
  evidence:
  - reference: PMID:33239480
    reference_title: Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      retinopathy based on Scheie classification are often applied to evaluate
      the impact of hypertension and atherosclerosis.
    explanation: >-
      This supports Scheie-classified atherosclerotic retinopathy as the
      clinical retinal arteriolar sclerosis phenotype.
  - reference: PMID:26133318
    reference_title: Association between Ophthalmological Changes and Cardiovascular Diseases in Patients with Chronic Kidney Disease Undergoing Hemodialysis.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Significant correlations were found between the presence of
      arteriosclerotic retinopathy
    explanation: >-
      This hemodialysis cohort directly studied arteriosclerotic retinopathy
      graded by Scheie S grade.
  downstream:
  - target: Retinopathy
    description: Retinal arteriolar remodeling contributes to clinically visible retinopathy.
    evidence:
    - reference: PMID:33239480
      reference_title: Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        retinopathy based on Scheie classification are often applied to evaluate
        the impact of hypertension and atherosclerosis.
      explanation: >-
        Scheie-classified atherosclerotic retinopathy links retinal arteriolar
        sclerosis with visible retinopathy grading.
- name: Systemic vascular stiffness and atherosclerosis association
  description: >-
    Arteriosclerotic retinal findings track with systemic vascular stiffness and
    macrovascular atherosclerotic burden, supporting the use of retinal vascular
    imaging as a noninvasive systemic vascular biomarker.
  locations:
  - preferred_term: retina
    term:
      id: UBERON:0000966
      label: retina
  biological_processes:
  - preferred_term: blood vessel remodeling
    modifier: ABNORMAL
    term:
      id: GO:0001974
      label: blood vessel remodeling
  evidence:
  - reference: PMID:33239480
    reference_title: Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      atherosclerotic retinopathy was significantly associated with CAVI and
      carotid IMT.
    explanation: >-
      The study links Scheie-defined atherosclerotic retinal lesions with
      functional and morphologic large-artery atherosclerosis measures.
  - reference: PMID:37968750
    reference_title: "Sex-specific association between carotid atherosclerosis and fundus arteriosclerosis in a Chinese population: a retrospective cross-sectional study."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      fundus arteriosclerosis was significantly associated with the risk of
      carotid atherosclerosis.
    explanation: >-
      The large health-examination cohort supports a clinically relevant
      fundus-arteriosclerosis association with carotid atherosclerosis.
  downstream:
  - target: Cardiovascular disease risk stratification
    description: Retinal microvascular findings can contribute to systemic vascular risk assessment.
    evidence:
    - reference: PMID:26133318
      reference_title: Association between Ophthalmological Changes and Cardiovascular Diseases in Patients with Chronic Kidney Disease Undergoing Hemodialysis.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        ophthalmoscopic examination may be a useful tool for predicting arterial
        stiffness
      explanation: >-
        The study supports using Scheie S grade as a noninvasive marker of
        arterial stiffness and cardiovascular disease association.
phenotypes:
- category: Ophthalmologic
  name: Retinopathy
  description: >-
    Noninflammatory retinal vascular abnormalities are the defining ocular
    manifestation of arteriosclerotic retinopathy.
  phenotype_term:
    preferred_term: Retinopathy
    term:
      id: HP:0000488
      label: Retinopathy
  evidence:
  - reference: PMID:33239480
    reference_title: Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The absence or presence and extent of retinopathy were characterized by
      ophthalmologists
    explanation: >-
      The study operationalized both hypertensive and atherosclerotic retinal
      lesions as retinopathy grades.
- category: Ophthalmologic
  name: Retinal arteriolar narrowing
  description: >-
    Narrowing of retinal arterioles is a characteristic ophthalmoscopic feature
    of arteriosclerotic remodeling.
  phenotype_term:
    preferred_term: Attenuation of retinal blood vessels
    term:
      id: HP:0007843
      label: Attenuation of retinal blood vessels
  evidence:
  - reference: PMID:38793083
    reference_title: Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease.
    supports: PARTIAL
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      A narrower CRAE, wider CRVE and a lower AVR have been associated with
      increased cardiovascular events.
    explanation: >-
      CRAE is an arteriolar-caliber metric; the review supports narrowed retinal
      arterioles as a vascular-risk imaging feature, although not specific to
      Scheie-defined arteriosclerotic retinopathy.
- category: Ophthalmologic
  name: Enhanced retinal arteriolar light reflex
  description: >-
    Increased retinal arteriolar light reflex, including classic copper- or
    silver-wiring descriptions, is a visible retinal vessel wall sign associated
    with vascular risk factors and retinal vascular disease.
  evidence:
  - reference: PMID:17070582
    reference_title: "Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The enhanced arteriolar light reflex sign was found in 1053 participants
      (31.7%
    explanation: >-
      This population study supports enhanced arteriolar light reflex as a
      common retinal arteriolar wall sign.
- category: Ophthalmologic
  name: Arteriovenous nicking
  description: >-
    Arteriovenous nicking is an arteriolar-venular crossing sign that commonly
    clusters with enhanced arteriolar light reflex and retinopathy.
  evidence:
  - reference: PMID:17070582
    reference_title: "Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      arteriovenous nicking (OR 3.12) or retinopathy (OR 1.96).
    explanation: >-
      The study shows that enhanced arteriolar light reflex is strongly
      associated with arteriovenous nicking and retinopathy.
biochemical:
- name: Serum uric acid trajectory
  presence: Higher trajectory
  biomarker_term:
    preferred_term: serum uric acid trajectory
  notes: >-
    Longitudinal serum uric-acid trajectory is a sex-specific biochemical risk
    marker for incident retinal arteriosclerosis in the reported cohort.
  evidence:
  - reference: PMID:36926048
    reference_title: "Sex-specific association of serum uric acid trajectories with risk of incident retinal arteriosclerosis in Chinese population: A population-based longitudinal study."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Higher SUA trajectory groups were significantly associated with an
      increased risk of incident retinal arteriosclerosis in men
    explanation: >-
      This longitudinal cohort supports higher serum uric acid trajectories as
      a male-specific risk marker for incident retinal arteriosclerosis.
genetic: []
environmental:
- name: Hypertension
  presence: Positive
  description: >-
    Hypertension is a major systemic vascular context in which Scheie
    retinopathy grading is applied and atherosclerotic retinal lesions are
    evaluated.
  evidence:
  - reference: PMID:33239480
    reference_title: Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      evaluate the impact of hypertension and atherosclerosis.
    explanation: >-
      The study explicitly frames Scheie retinopathy grading as a way to
      evaluate hypertension and atherosclerosis effects in the ocular fundus.
- name: Heavy alcohol consumption
  presence: Positive
  description: >-
    Heavy alcohol consumption was associated with marked enhanced retinal
    arteriolar light reflex in the Blue Mountains Eye Study cohort.
  evidence:
  - reference: PMID:17070582
    reference_title: "Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Markedly enhanced light reflex was significantly associated with mean
      arterial blood pressure (OR 1.24), heavy alcohol consumption (OR 2.66, >
      or = 40 grams alcohol per day), and serum glucose (OR 1.16).
    explanation: >-
      This directly supports heavy alcohol consumption as a systemic risk factor
      associated with marked enhanced retinal arteriolar light reflex.
- name: Dyslipidemia
  presence: Positive
  description: >-
    Lipid abnormalities, including higher total cholesterol, LDL cholesterol,
    and triglycerides, were associated with enhanced retinal arteriolar light
    reflex.
  evidence:
  - reference: PMID:17070582
    reference_title: "Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      mildly enhanced light reflex was significantly associated with serum
      glucose (OR 1.11 per SD increase), total cholesterol (OR 1.11),
      low-density lipoprotein (OR 1.55), triglycerides (OR 1.11)
    explanation: >-
      This supports dyslipidemia-related measures as risk correlates of
      enhanced retinal arteriolar light reflex.
- name: Serum glucose dysregulation
  presence: Positive
  description: >-
    Higher serum glucose was associated with both mild and marked enhanced
    retinal arteriolar light reflex, consistent with a metabolic vascular-risk
    context.
  evidence:
  - reference: PMID:17070582
    reference_title: "Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      serum glucose (OR 1.11 per SD increase)
    explanation: >-
      This supports serum glucose as a metabolic factor associated with mildly
      enhanced retinal arteriolar light reflex.
  - reference: PMID:17070582
    reference_title: "Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      serum glucose (OR 1.16).
    explanation: >-
      This supports serum glucose as a metabolic factor associated with markedly
      enhanced retinal arteriolar light reflex.
- name: Chronic kidney disease on hemodialysis
  presence: Risk context
  description: >-
    Chronic kidney disease requiring hemodialysis is a clinical context in which
    retinal arterial sclerosis has been associated with arterial stiffness and
    prior cardiovascular disease.
  evidence:
  - reference: PMID:26133318
    reference_title: Association between Ophthalmological Changes and Cardiovascular Diseases in Patients with Chronic Kidney Disease Undergoing Hemodialysis.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD)
      have a high prevalence of cardiovascular diseases
    explanation: >-
      The study directly examined retinal arterial sclerosis in a CKD
      hemodialysis cohort with high cardiovascular disease burden.
diagnosis:
- name: Fundus photography with Scheie or KWB grading
  description: >-
    Ophthalmologist-graded fundus photography is the core diagnostic and
    epidemiologic method for identifying Scheie atherosclerotic grades and KWB
    fundus arteriosclerosis categories.
  diagnosis_term:
    preferred_term: clinical assessment
    term:
      id: MAXO:0000487
      label: clinical assessment
  results: Retinopathy grade, fundus arteriosclerosis grade, arteriolar light reflex, and arteriovenous crossing signs.
  evidence:
  - reference: PMID:33239480
    reference_title: Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      characterized by ophthalmologists as hypertensive (H0-4) and
      atherosclerotic grades (S0-4)
    explanation: >-
      This supports ophthalmologist-graded Scheie H and S grades as a diagnostic
      classification approach.
  - reference: PMID:37968750
    reference_title: "Sex-specific association between carotid atherosclerosis and fundus arteriosclerosis in a Chinese population: a retrospective cross-sectional study."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Two trained ophthalmologists analysed fundus arteriosclerosis based on
      fundus photographs
    explanation: >-
      The study supports fundus photography reviewed by ophthalmologists for
      identifying fundus arteriosclerosis.
- name: OCT and OCTA retinal vascular biomarker assessment
  description: >-
    Optical coherence tomography and OCT angiography can quantify retinal
    structural and vascular features used as systemic cardiovascular biomarkers,
    complementing classic fundus grading rather than replacing it.
  diagnosis_term:
    preferred_term: optical coherence tomography
    term:
      id: MAXO:0000969
      label: optical coherence tomography
  results: Retinal thickness, choroidal thickness, vessel density, and foveal avascular zone measurements.
  evidence:
  - reference: PMID:38672719
    reference_title: "Retinal Structural and Vascular Changes in Patients with Coronary Artery Disease: A Systematic Review and Meta-Analysis."
    supports: PARTIAL
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      retinal vasculature as a biomarker for diagnosis and monitoring of
      patients with coronary artery disease
    explanation: >-
      This systematic review supports OCT/OCTA-derived retinal vascular
      assessment as a cardiovascular biomarker; it is not specific to classic
      Scheie arteriosclerotic retinopathy.
  - reference: PMID:38793083
    reference_title: Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease.
    supports: PARTIAL
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      fundus images can be taken and analysed.
    explanation: >-
      This review supports noninvasive retinal vessel analysis for quantifying
      cardiovascular microvascular changes.
treatments:
- name: Cardiovascular risk-factor management and retinal surveillance
  description: >-
    No disease-specific ocular pharmacotherapy was identified in the Falcon
    report. Practical management is prevention-oriented: identify and treat
    systemic vascular risk factors and monitor retinal vascular signs over time.
  treatment_term:
    preferred_term: cardiovascular risk-factor management
  target_mechanisms:
  - target: Systemic vascular stiffness and atherosclerosis association
    treatment_effect: MODULATES
    description: >-
      Risk-factor control targets the systemic vascular disease context that is
      associated with retinal arteriosclerosis rather than reversing established
      retinal arteriolar sclerosis directly.
    evidence:
    - reference: PMID:33239480
      reference_title: Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
      supports: PARTIAL
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        CAVI and carotid IMT are independent determinants of retinopathy.
      explanation: >-
        This supports targeting systemic arterial stiffness and atherosclerosis
        risk as a management rationale, while not proving direct treatment
        reversal of retinal lesions.
  evidence:
  - reference: PMID:33239480
    reference_title: Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
    supports: PARTIAL
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      CAVI and carotid IMT are independent determinants of retinopathy.
    explanation: >-
      This supports a systemic vascular-risk management rationale, although it
      is observational rather than an intervention trial.
  - reference: PMID:38793083
    reference_title: Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease.
    supports: PARTIAL
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Retinal vascular imaging using AI may help identify the cardiovascular
      risk
    explanation: >-
      This supports retinal vascular imaging as a prevention and surveillance
      tool for cardiovascular risk.
datasets: []
animal_models: []
references:
- reference: DOI:10.5551/jat.59857
  title: Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Scheie-defined atherosclerotic retinopathy is associated with CAVI and carotid IMT.
    supporting_text: >-
      atherosclerotic retinopathy was significantly associated with CAVI and
      carotid IMT.
- reference: DOI:10.5551/jat.30601
  title: Association between Ophthalmological Changes and Cardiovascular Diseases in Patients with Chronic Kidney Disease Undergoing Hemodialysis.
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Scheie S grade correlates with arterial stiffness and prior cardiovascular disease in a hemodialysis cohort.
    supporting_text: >-
      Significant correlations were found between the presence of
      arteriosclerotic retinopathy
- reference: DOI:10.1016/j.ophtha.2006.06.046
  title: "Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign."
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Enhanced retinal arteriolar light reflex is common and associated with AV nicking and retinopathy.
    supporting_text: >-
      arteriovenous nicking (OR 3.12) or retinopathy (OR 1.96).
- reference: DOI:10.3389/fcvm.2023.1116486
  title: "Sex-specific association of serum uric acid trajectories with risk of incident retinal arteriosclerosis in Chinese population: A population-based longitudinal study."
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Higher serum uric acid trajectories are associated with incident retinal arteriosclerosis in men.
    supporting_text: >-
      Higher SUA trajectory groups were significantly associated with an
      increased risk of incident retinal arteriosclerosis in men
- reference: DOI:10.1186/s40001-023-01508-6
  title: "Sex-specific association between carotid atherosclerosis and fundus arteriosclerosis in a Chinese population: a retrospective cross-sectional study."
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Fundus arteriosclerosis is associated with carotid atherosclerosis.
    supporting_text: >-
      fundus arteriosclerosis was significantly associated with the risk of
      carotid atherosclerosis.
- reference: DOI:10.1038/s41598-023-38378-1
  title: "Association between total bilirubin and gender-specific incidence of fundus arteriosclerosis in a Chinese population: a retrospective cohort study"
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Serum total bilirubin was assessed as a sex-specific incident fundus arteriosclerosis risk marker.
- reference: DOI:10.3390/life14040448
  title: "Retinal Structural and Vascular Changes in Patients with Coronary Artery Disease: A Systematic Review and Meta-Analysis."
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: OCT/OCTA retinal vascular features can serve as cardiovascular biomarkers.
    supporting_text: >-
      retinal vasculature as a biomarker for diagnosis and monitoring of
      patients with coronary artery disease
- reference: DOI:10.3390/jpm14050501
  title: Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease.
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Retinal vessel analysis can support cardiovascular risk identification and prevention.
    supporting_text: >-
      Retinal vascular imaging using AI may help identify the cardiovascular
      risk
- reference: DOI:10.1007/s00415-023-12171-6
  title: "Retinal imaging for the assessment of stroke risk: a systematic review"
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Retinal imaging biomarkers were reviewed for prospective stroke-risk assessment.
- reference: DOI:10.1167/tvst.12.7.14
  title: A Systematic Review and Meta-Analysis of Applying Deep Learning in the Prediction of the Risk of Cardiovascular Diseases From Retinal Images
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Deep-learning models using retinal images were reviewed for cardiovascular risk prediction.
- reference: DOI:10.3390/jpm13111564
  title: "Retinal Findings and Cardiovascular Risk: Prognostic Conditions, Novel Biomarkers, and Emerging Image Analysis Techniques"
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Retinal findings and imaging biomarkers were reviewed as cardiovascular prognostic tools.
- reference: DOI:10.3390/jcdd12060230
  title: "Retinal Imaging as a Window into Cardiovascular Health: Towards Harnessing Retinal Analytics for Precision Cardiovascular Medicine"
  found_in:
  - Arteriosclerotic_Retinopathy-deep-research-falcon.md
  findings:
  - statement: Retinal analytics were reviewed as tools for precision cardiovascular medicine.
📚

References & Deep Research

References

12
DOI:10.5551/jat.59857
Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals.
1 finding
Scheie-defined atherosclerotic retinopathy is associated with CAVI and carotid IMT.
"atherosclerotic retinopathy was significantly associated with CAVI and carotid IMT."
DOI:10.5551/jat.30601
Association between Ophthalmological Changes and Cardiovascular Diseases in Patients with Chronic Kidney Disease Undergoing Hemodialysis.
1 finding
Scheie S grade correlates with arterial stiffness and prior cardiovascular disease in a hemodialysis cohort.
"Significant correlations were found between the presence of arteriosclerotic retinopathy"
DOI:10.1016/j.ophtha.2006.06.046
Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign.
1 finding
Enhanced retinal arteriolar light reflex is common and associated with AV nicking and retinopathy.
"arteriovenous nicking (OR 3.12) or retinopathy (OR 1.96)."
DOI:10.3389/fcvm.2023.1116486
Sex-specific association of serum uric acid trajectories with risk of incident retinal arteriosclerosis in Chinese population: A population-based longitudinal study.
1 finding
Higher serum uric acid trajectories are associated with incident retinal arteriosclerosis in men.
"Higher SUA trajectory groups were significantly associated with an increased risk of incident retinal arteriosclerosis in men"
DOI:10.1186/s40001-023-01508-6
Sex-specific association between carotid atherosclerosis and fundus arteriosclerosis in a Chinese population: a retrospective cross-sectional study.
1 finding
Fundus arteriosclerosis is associated with carotid atherosclerosis.
"fundus arteriosclerosis was significantly associated with the risk of carotid atherosclerosis."
DOI:10.1038/s41598-023-38378-1
Association between total bilirubin and gender-specific incidence of fundus arteriosclerosis in a Chinese population: a retrospective cohort study
1 finding
Serum total bilirubin was assessed as a sex-specific incident fundus arteriosclerosis risk marker.
DOI:10.3390/life14040448
Retinal Structural and Vascular Changes in Patients with Coronary Artery Disease: A Systematic Review and Meta-Analysis.
1 finding
OCT/OCTA retinal vascular features can serve as cardiovascular biomarkers.
"retinal vasculature as a biomarker for diagnosis and monitoring of patients with coronary artery disease"
DOI:10.3390/jpm14050501
Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease.
1 finding
Retinal vessel analysis can support cardiovascular risk identification and prevention.
"Retinal vascular imaging using AI may help identify the cardiovascular risk"
DOI:10.1007/s00415-023-12171-6
Retinal imaging for the assessment of stroke risk: a systematic review
1 finding
Retinal imaging biomarkers were reviewed for prospective stroke-risk assessment.
DOI:10.1167/tvst.12.7.14
A Systematic Review and Meta-Analysis of Applying Deep Learning in the Prediction of the Risk of Cardiovascular Diseases From Retinal Images
1 finding
Deep-learning models using retinal images were reviewed for cardiovascular risk prediction.
DOI:10.3390/jpm13111564
Retinal Findings and Cardiovascular Risk: Prognostic Conditions, Novel Biomarkers, and Emerging Image Analysis Techniques
1 finding
Retinal findings and imaging biomarkers were reviewed as cardiovascular prognostic tools.
DOI:10.3390/jcdd12060230
Retinal Imaging as a Window into Cardiovascular Health: Towards Harnessing Retinal Analytics for Precision Cardiovascular Medicine
1 finding
Retinal analytics were reviewed as tools for precision cardiovascular medicine.

Deep Research

1
Falcon ▸
1. Disease Information
Edison Scientific Literature 29 citations 2026-05-06T13:43:16.992744

1. Disease Information

1.1 Disease overview (current understanding)

Arteriosclerotic retinopathy denotes chronic retinal arteriolar remodeling/“hardening” related to arteriosclerosis/atherosclerosis and long-standing vascular risk exposure. In one clinical definition used in CKD/hemodialysis research, arteriosclerotic retinopathy is described as a lesion characterized by “medial layer hypertrophy, hyalinization of the intima, and hyperplasia of the endothelial layer of the vessel wall.” (nokiba2015associationbetweenophthalmological pages 1-3)

In practice, the term overlaps with chronic components of hypertensive retinopathy (arteriolar sclerosis) and with population screening terms such as “fundus arteriosclerosis.” (liu2023sexspecificassociationbetween pages 3-4, sugiura2022examinationoflarge media a2b302a2)

1.2 Key identifiers (ontology/coding)

  • MONDO / OMIM / Orphanet: Not identified in the retrieved primary literature excerpts; this entity is commonly treated as a clinical sign/phenotype complex rather than a monogenic disorder. (No specific MONDO/OMIM/Orphanet identifier found in available texts.)
  • MeSH / ICD-10/ICD-11: Not extractable from the retrieved texts using available tools/evidence; many studies define the phenotype via fundus grading systems rather than billing codes. (liu2023sexspecificassociationbetween pages 3-4, sugiura2022examinationoflarge media a2b302a2)

1.3 Synonyms / alternative names

Commonly used overlapping terms in the retrieved literature: * Fundus arteriosclerosis (liu2023sexspecificassociationbetween pages 3-4) * Retinal arteriosclerosis / atherosclerotic retinopathy (Scheie S grading) (sugiura2022examinationoflarge pages 2-4, sugiura2022examinationoflarge media a2b302a2) * Arteriolar light reflex enhancement / copper-wiring / silver-wiring (as a sign within arteriosclerotic/hypertensive grading) (kaushik2007prevalenceandassociations pages 1-3, sugiura2022examinationoflarge media a2b302a2)

1.4 Evidence sources

The information above is derived from aggregated disease-level resources in cohort studies, systematic reviews, and clinical definitions rather than single case reports. (kaushik2007prevalenceandassociations pages 1-3, liu2023sexspecificassociationbetween pages 3-4, rusu2024retinalstructuraland pages 1-2, geng2023sexspecificassociationof pages 1-2)

2. Etiology

2.1 Primary causal factors (multifactorial)

Arteriosclerotic retinopathy is best understood as a microvascular end-organ manifestation of chronic systemic vascular stressors rather than a single causal gene disorder. Mechanistically, the phenotype reflects chronic arteriolar wall remodeling and sclerosis (see §6). (nokiba2015associationbetweenophthalmological pages 1-3)

2.2 Risk factors (recent human evidence)

Metabolic and vascular risk factors are consistently associated with arteriosclerotic retinal signs:

  • Hypertension, diabetes, dyslipidemia, CKD: In a cohort of untreated middle-aged workers (n=7,730), unadjusted odds ratios for atherosclerotic retinopathy (Scheie S1+S2) were elevated for CKD (OR 2.88), hypertension (OR 3.27), dyslipidemia (OR 1.26), and diabetes (OR 5.98). (sugiura2022examinationoflarge pages 12-13)
  • Serum uric acid trajectory (sex-specific): In a 2010 baseline cohort followed to 2019 (n=4,324), men in higher SUA trajectory groups had higher incidence of retinal arteriosclerosis (moderate-high vs low: HR 1.76; high vs low: HR 1.81), while women did not show the same pattern. (geng2023sexspecificassociationof pages 1-2)

2.3 Protective factors

Clear protective factors are less consistently reported; however, biomarkers sometimes proposed as protective against systemic atherosclerosis can show complex/sex-specific associations in retinal endpoints.

  • Total bilirubin (TBIL): A large retrospective cohort (n=27,477; 2006–2019) found higher TBIL quartiles were associated with higher risk of incident fundus arteriosclerosis in males (Q4 vs Q1 HR 1.396), with no significant association in females. This directionality suggests TBIL is not protective in this cohort/definition and underscores possible confounding or non-linear biology. (nokiba2015associationbetweenophthalmological pages 1-3)

2.4 Gene–environment interactions

Direct gene–environment interaction evidence specific to arteriosclerotic retinopathy was not captured in the retrieved texts. Some broader retinal microvascular biomarker literature acknowledges genetic influences on retinal traits, but disease-specific G×E results were not retrievable here. (iorga2024noninvasiveretinalvessel pages 5-7)

3. Phenotypes

3.1 Key clinical signs and grading (Scheie)

The most widely operationalized phenotype definition in the retrieved sources is Scheie atherosclerotic retinopathy S0–S4 and hypertensive retinopathy H0–H4, evaluated from fundus examination/photography.

Scheie atherosclerotic retinopathy (S) grading (definitions): * S0: Normal * S1: Broadening of the light reflex from the arteriole with minimal/no AV compression * S2: Light reflex and crossing changes more prominent * S3: “Copper wire” appearance with more prominent AV compression * S4: “Silver” appearance with most severe AV crossing changes (sugiura2022examinationoflarge media a2b302a2)

Scheie hypertensive retinopathy (H) grading (definitions): * H0: Normal * H1: Barely detectable arterial narrowing * H2: Obvious arterial narrowing with focal irregularities plus light reflex changes * H3: H2 plus retinal hemorrhages and/or exudates * H4: H3 plus papilledema (sugiura2022examinationoflarge media a2b302a2)

A figure region containing the above grading definitions was retrieved from the Sugiura et al. paper (visual evidence). (sugiura2022examinationoflarge media a2b302a2)

3.2 Population frequency (examples)

  • Enhanced arteriolar light reflex (a related arteriosclerotic sign): In the Blue Mountains Eye Study (n=3,654; ≥49 years), enhanced retinal arteriolar light reflex was common (31.7% overall; 28.8% mild, 2.9% marked). Mild enhancement was strongly associated with AV nicking (OR 3.12) and with retinopathy (OR 1.96). (kaushik2007prevalenceandassociations pages 1-3)
  • Scheie-defined retinopathy prevalence in untreated middle-aged workers: In Sugiura et al. (n=7,730; ages 35–61), hypertensive retinopathy (H1+H2) prevalence was 2.8%, while atherosclerotic retinopathy (S1+S2) prevalence was 13.6%. (sugiura2022examinationoflarge pages 12-13)

3.3 Symptomatology and QoL impact

Arteriosclerotic retinopathy is often asymptomatic until complications occur (e.g., occlusive disease, macular edema in related conditions). The retrieved evidence focused on imaging signs and systemic associations rather than patient-reported quality-of-life instruments; no EQ-5D/SF-36 metrics were found in the available texts. (liu2023sexspecificassociationbetween pages 3-4, rusu2024retinalstructuraland pages 1-2)

3.4 Suggested HPO terms (phenotype mapping; best-fit suggestions)

(These are ontology suggestions; exact HPO IDs should be verified in HPO.) * Retinal arteriolar narrowing (sign) (supported conceptually by Scheie H grades and retinal arteriolar narrowing) (sugiura2022examinationoflarge media a2b302a2) * Arteriovenous nicking (sign) (kaushik2007prevalenceandassociations pages 1-3, sugiura2022examinationoflarge media a2b302a2) * Increased retinal arteriolar light reflex / copper wiring / silver wiring (sign) (kaushik2007prevalenceandassociations pages 1-3, sugiura2022examinationoflarge media a2b302a2) * Retinal hemorrhage / hard exudates / cotton wool spots / papilledema (primarily severe hypertensive retinopathy features) (sugiura2022examinationoflarge media a2b302a2)

4. Genetic/Molecular Information

4.1 Causal genes and pathogenic variants

No causal genes or pathogenic variants were identified in the retrieved sources for arteriosclerotic retinopathy as a discrete genetic disorder. The current evidence base in this tool run supports arteriosclerotic retinopathy as a complex trait/end-organ phenotype rather than a Mendelian condition. (iorga2024noninvasiveretinalvessel pages 5-7)

4.2 Modifier genes / epigenetics / chromosomal abnormalities

Not identified in the retrieved evidence. (iorga2024noninvasiveretinalvessel pages 5-7)

5. Environmental Information

5.1 Lifestyle and environmental factors

  • Heavy alcohol intake was associated with marked enhanced arteriolar light reflex in the Blue Mountains Eye Study (OR 2.66 for ≥40 g/day). (kaushik2007prevalenceandassociations pages 1-3)
  • Traditional cardiovascular risk factors (smoking, BMI/obesity, lipid and glucose measures) were associated with enhanced light reflex and/or Scheie-defined retinopathy in population studies. (kaushik2007prevalenceandassociations pages 1-3, sugiura2022examinationoflarge pages 12-13)

5.2 Infectious agents

No infectious etiology is supported in retrieved texts. (nokiba2015associationbetweenophthalmological pages 1-3)

6. Mechanism / Pathophysiology

6.1 Causal chain (conceptual)

Chronic systemic vascular risk exposure (hypertension, diabetes, dyslipidemia, CKD-related mineral/inflammatory milieu) → endothelial dysfunction and vascular remodeling → retinal arteriolar wall thickening/sclerosis (medial hypertrophy, intimal hyalinization, endothelial hyperplasia) → ophthalmoscopic signs (increased light reflex “copper/silver wiring”, AV crossing changes, arteriolar narrowing) → associations with systemic arterial stiffness and atherosclerotic burden. (nokiba2015associationbetweenophthalmological pages 1-3, nokiba2015associationbetweenophthalmological pages 3-4, sugiura2022examinationoflarge media a2b302a2)

6.2 Histopathology-linked description

A clinical pathologic description in CKD/hemodialysis literature emphasizes that arteriosclerotic retinopathy reflects vascular wall remodeling with “medial layer hypertrophy, hyalinization of the intima, and hyperplasia of the endothelial layer.” (nokiba2015associationbetweenophthalmological pages 1-3)

6.3 Microvascular–macrovascular coupling (human data)

Evidence supports that retinal arteriosclerotic findings track systemic vascular disease: * In hemodialysis patients (n=44), Scheie S grade correlated with arterial stiffness (PWV) and past CVD (reported p=0.001 and p=0.045). (nokiba2015associationbetweenophthalmological pages 1-3) * In untreated middle-aged adults (n=7,730), measures of large-artery atherosclerosis/stiffness—carotid IMT and CAVI—were independently associated with Scheie-defined retinopathy; carotid IMT per 0.1 mm showed ORs around ~1.18 for retinopathy in multivariable models. (sugiura2022examinationoflarge pages 7-9, sugiura2022examinationoflarge pages 6-7) * In a large cross-sectional health-exam sample (n=20,836), fundus arteriosclerosis was associated with carotid atherosclerosis (adjusted OR 1.17). (liu2023sexspecificassociationbetween pages 3-4)

6.4 Molecular pathways / immune involvement (evidence level)

The retrieved texts emphasize general vascular mechanisms (endothelial dysfunction, oxidative stress, inflammation) in the context of systemic vascular disease and retinal microvasculature but do not provide disease-specific retinal transcriptomic/proteomic signatures for arteriosclerotic retinopathy. (nokiba2015associationbetweenophthalmological pages 1-3, bisen2025retinalimagingas pages 5-8)

6.5 Suggested ontology terms

GO (biological process) suggestions (verify IDs): * Blood vessel remodeling; extracellular matrix organization; regulation of vascular smooth muscle cell proliferation; response to oxidative stress; inflammatory response (conceptually consistent with sclerosis/remodeling and inflammation noted as risk factors). (nokiba2015associationbetweenophthalmological pages 1-3)

CL (cell type) suggestions (verify IDs): * Vascular endothelial cell; vascular smooth muscle cell/pericyte (arteriolar wall remodeling). (nokiba2015associationbetweenophthalmological pages 1-3)

7. Anatomical Structures Affected

7.1 Organ/tissue/cell targets

  • Primary organ/tissue: Retina (retinal arterioles; AV crossings). (sugiura2022examinationoflarge media a2b302a2)
  • Vascular structures: Retinal arterioles and arteriovenous crossings. (sugiura2022examinationoflarge media a2b302a2)

UBERON suggestions (verify IDs): retina; retinal blood vessel; retinal arteriole.

7.2 Laterality

Generally bilateral in systemic disease, but laterality was not specified in retrieved texts.

8. Temporal Development

8.1 Onset and course

Arteriosclerotic retinal changes are typically chronic/insidious and accumulate with age and vascular risk exposure. In middle-aged workers (mean ~45 years), Scheie S1+S2 prevalence was already ~13.6%, supporting early/midlife detectability. (sugiura2022examinationoflarge pages 12-13, sugiura2022examinationoflarge pages 1-2)

8.2 Staging

Scheie S0–S4 provides a practical staging framework from normal through copper/silver wiring and severe AV crossing changes. (sugiura2022examinationoflarge media a2b302a2)

9. Inheritance and Population

9.1 Epidemiology (available statistics)

Population-based frequencies depend heavily on definitions: * Enhanced arteriolar light reflex prevalence: 31.7% in a ≥49-year cohort. (kaushik2007prevalenceandassociations pages 1-3) * Scheie-defined atherosclerotic retinopathy (S1+S2): 13.6% in untreated workers aged 35–61. (sugiura2022examinationoflarge pages 12-13)

Incidence data from a longitudinal study: * Retinal arteriosclerosis events over ~9.5 years: 295 men and 97 women among 4,324 adults initially free of retinal arteriosclerosis. (geng2023sexspecificassociationof pages 1-2)

9.2 Demographics and sex effects

Sex-specific associations have been reported for biochemical predictors (e.g., SUA trajectories and TBIL associations stronger in men). (geng2023sexspecificassociationof pages 1-2, nokiba2015associationbetweenophthalmological pages 1-3)

10. Diagnostics

10.1 Clinical and imaging tests (current practice)

Fundus examination / fundus photography is the core diagnostic modality for Scheie and KWB grading. * Sugiura et al. used non-mydriatic fundus photographs graded by ophthalmologists according to Scheie H and S grades. (sugiura2022examinationoflarge pages 2-4, sugiura2022examinationoflarge media a2b302a2) * Liu et al. used standardized nonmydriatic fundus photography with two trained ophthalmologists grading KWB-based fundus arteriosclerosis. (liu2023sexspecificassociationbetween pages 3-4)

OCT and OCTA (modern developments; 2024 evidence): * A 2024 systematic review/meta-analysis of CAD studies supports that OCT/OCTA capture retinal structural and microvascular signatures in systemic CAD, including reduced RNFL thickness and reduced vessel density with expanded FAZ in CAD. (rusu2024retinalstructuraland pages 1-2) * A 2024 review describes limitations and strengths of OCTA vs fundus-photo vessel measurement and summarizes normative CRAE/CRVE/AVR metrics. (iorga2024noninvasiveretinalvessel pages 5-7)

10.2 Biomarkers

Biochemical predictors investigated in recent cohorts include serum uric acid trajectories (incident retinal arteriosclerosis in men) and total bilirubin quartiles (risk in males). (geng2023sexspecificassociationof pages 1-2, nokiba2015associationbetweenophthalmological pages 1-3)

10.3 Differential diagnosis

Not systematically addressed in retrieved texts, but clinically overlaps with: * Hypertensive retinopathy (acute and chronic stages) * Diabetic retinopathy (microaneurysms/hemorrhages/exudates) * Retinal vein/artery occlusions (acute ischemic presentations)

The current evidence set emphasizes that arteriosclerotic signs (light reflex and crossing changes) are often embedded within hypertensive retinopathy staging systems. (sugiura2022examinationoflarge media a2b302a2)

11. Outcome / Prognosis

11.1 Systemic vascular prognosis (associative)

Arteriosclerotic retinal signs and retinal microvascular biomarkers are repeatedly associated with systemic vascular disease burden: * Fundus arteriosclerosis associated with carotid atherosclerosis (adjusted OR 1.17). (liu2023sexspecificassociationbetween pages 3-4) * Scheie grades correlated with arterial stiffness and CVD history in hemodialysis patients. (nokiba2015associationbetweenophthalmological pages 1-3)

11.2 Ocular prognosis

The retrieved texts did not provide direct longitudinal estimates of vision loss attributable specifically to arteriosclerotic retinopathy without occlusive events. However, retinal microvascular compromise is positioned as part of a continuum toward ischemic retinal complications and systemic vascular events. (bisen2025retinalimagingas pages 5-8, rusu2024retinalstructuraland pages 1-2)

12. Treatment

12.1 Disease-specific therapy

No disease-specific ocular therapy for isolated arteriosclerotic retinopathy is established in the retrieved literature; management typically targets systemic risk factor modification and surveillance.

12.2 Risk factor management (real-world implementation)

Given strong associations with hypertension, diabetes, dyslipidemia, and CKD, real-world management aligns with cardiovascular risk reduction. Supporting evidence includes the strong unadjusted associations of these conditions with Scheie-defined retinopathy in population screening. (sugiura2022examinationoflarge pages 12-13)

12.3 MAXO term suggestions (verify IDs)

  • Antihypertensive therapy; lipid-lowering therapy; diabetes management; smoking cessation counseling; screening fundus photography; optical coherence tomography angiography.

13. Prevention

13.1 Primary prevention

  • Control of hypertension, diabetes, dyslipidemia, and CKD-related risk likely reduces development/progression of retinal arteriosclerotic changes; population data show these factors are strongly associated with prevalent Scheie-defined lesions. (sugiura2022examinationoflarge pages 12-13)

13.2 Secondary prevention / screening

Screening and risk stratification using fundus photography and retinal analytics is an active area: * A 2023 deep-learning meta-analysis supports that retinal-image-based models can predict multiple CVD risk-related outcomes and future CVD events with AUROC ~0.68–0.81 in some studies, but emphasizes need for validation for real-world adoption. (nokiba2015associationbetweenophthalmological pages 1-3) * A 2024 review argues retinal microvascular biomarkers (e.g., CRAE/CRVE/AVR; dynamic retinal vessel analysis; AI systems) could aid screening and treatment monitoring for CVD. (iorga2024noninvasiveretinalvessel pages 5-7)

14. Other Species / Natural Disease

No naturally occurring veterinary analogs were identified in the retrieved evidence set for “arteriosclerotic retinopathy” as a named entity.

15. Model Organisms

No specific model organism papers for retinal arteriosclerosis were retrieved in the available evidence. Mechanistic modeling is likely to rely on hypertension/atherosclerosis animal models with retinal vascular endpoints, but this could not be substantiated with the current evidence set.

Recent developments (2023–2024 highlight)

1) Large observational datasets are increasingly treating fundus arteriosclerosis as a quantitative marker linked to systemic atherosclerosis (e.g., carotid ultrasound associations; sex-specific effects). (liu2023sexspecificassociationbetween pages 3-4, geng2023sexspecificassociationof pages 1-2) 2) OCT/OCTA biomarkers are being consolidated in systematic reviews as potential non-invasive correlates of coronary artery disease (reduced vessel density; larger FAZ; thinner RNFL/choroid). (rusu2024retinalstructuraland pages 1-2) 3) AI/deep learning and “retinal analytics” for cardiovascular risk prediction has matured into systematic evidence syntheses, with performance competitive with but not clearly superior to standard risk scores in current studies. (nokiba2015associationbetweenophthalmological pages 1-3)

Key quantitative evidence table (2023–2024 prioritized)

The following table consolidates the most relevant quantitative studies and syntheses captured in this run.

Study (first author, year) Design/Population (N, setting) Retinal phenotype definition (Scheie/KWB, vessel measures) Main findings with effect sizes (OR/HR/WMD etc.) Publication date PMID URL
Geng 2023 Population-based longitudinal study; N=4,324 adults aged 18–60 without retinal arteriosclerosis at baseline; exposure window 2006–2010, follow-up 2011–2019; Chinese health-examination cohort Incident retinal arteriosclerosis; study evaluated sex-specific serum uric acid (SUA) trajectory groups (low, moderate, moderate-high, high) as predictors of later retinal arteriosclerosis During median 9.54-year follow-up, 97 women and 295 men developed retinal arteriosclerosis. In men, moderate-high SUA trajectory vs low: HR 1.76 (95% CI 1.17–2.65); high trajectory vs low: HR 1.81 (95% CI 1.04–3.17). No significant increase in women for moderate-high trajectory: HR 0.77 (95% CI 0.39–1.52) (geng2023sexspecificassociationof pages 1-2) 2023-02-28 https://doi.org/10.3389/fcvm.2023.1116486
Liu 2023 Retrospective cross-sectional study; N=20,836 Chinese health-examination participants (13,050 male; 7,786 female) Fundus arteriosclerosis graded from standardized nonmydriatic fundus photographs using Keith–Wagener–Barker (KWB) grades 1–4; any grade 1–4 counted as fundus arteriosclerosis; carotid atherosclerosis assessed by Doppler ultrasound Carotid atherosclerosis incidence was higher in those with fundus arteriosclerosis (52.94% vs 47.06%). Adjusted association between fundus arteriosclerosis and carotid atherosclerosis: OR 1.17 (95% CI 1.02–1.34; p=0.0262); association significant in males but not females (liu2023sexspecificassociationbetween pages 3-4) 2023-11 https://doi.org/10.1186/s40001-023-01508-6
Dong 2023 Retrospective cohort study; N=27,477 Chinese participants, follow-up 2006–2019 Incident fundus arteriosclerosis; exposure was quartiles of serum total bilirubin (TBIL); fundus arteriosclerosis assessed in routine examinations In males, higher TBIL quartiles associated with higher fundus arteriosclerosis risk vs Q1: Q2 HR 1.217 (95% CI 1.095–1.354), Q3 HR 1.255 (95% CI 1.128–1.396), Q4 HR 1.396 (95% CI 1.254–1.555); linear dose-response reported. No significant association in females (nokiba2015associationbetweenophthalmological pages 1-3) 2023-07 https://doi.org/10.1038/s41598-023-38378-1
Rusu 2024 Systematic review and meta-analysis; 11 studies of CAD vs controls OCT/OCTA retinal structural and vascular biomarkers rather than classic Scheie/KWB lesions; included retinal thickness, RNFL, choroid, vessel density, FAZ CAD associated with thinner RNFL (WMD −3.11), thinner subfoveal choroid (WMD −58.79), lower overall retinal thickness (WMD −4.61), lower superficial foveal vessel density (WMD −2.19; p<0.0001), and larger FAZ (WMD 52.73; p=0.02), supporting retinal vascularization as a noninvasive CAD biomarker (rusu2024retinalstructuraland pages 1-2) 2024-03 https://doi.org/10.3390/life14040448
Iorga 2024 Narrative/systematic-style review of non-invasive retinal vessel analysis in cardiovascular disease Retinal vessel analysis metrics: CRAE, CRVE, AVR; fundus photography, dynamic retinal vessel analysis, OCTA Summarized normative Gutenberg Health Study metrics: mean CRAE 178.37 µm, CRVE 212.30 µm, AVR 0.84. Review notes uncontrolled hypertension example values CRAE 172.28 µm and AVR 0.81; hypertension strongly associated with lower AVR/CRAE, with tabulated ORs 2.703 for AVR and 2.881 for CRAE (p=0.001). Emphasizes AI systems (e.g., QUARTZ, SIVA-DLS) for scalable extraction of retinal vascular biomarkers (iorga2024noninvasiveretinalvessel pages 5-7) 2024-05 https://doi.org/10.3390/jpm14050501
Girach 2024 Systematic review of prospective studies assessing retinal imaging biomarkers for stroke risk; 24 studies included Retinal imaging biomarkers including vessel caliber, fractal dimension, tortuosity, retinopathy, emboli, AV nicking; fundus photography and limited OCT studies Review found wider retinal venules, lower fractal dimension, increased arteriolar tortuosity, retinopathy, and retinal emboli associated with higher stroke risk; evidence weaker for narrower arterioles and isolated AV nicking. AI models performed similarly to conventional risk scores but did not clearly outperform them (nokiba2015associationbetweenophthalmological pages 1-3) 2024-03 https://doi.org/10.1007/s00415-023-12171-6
Hu 2023 Systematic review and meta-analysis of deep learning for CVD risk prediction from retinal images; 26 studies Retinal-image-based DL using fundus photographs and retinal vascular morphology/geometry features rather than disease-specific Scheie grading Future CVD-event prediction studies reported AUROC 0.68–0.81. Pooled performance for related tasks: age MAE 3.19 years; gender AUROC 0.96; diabetes AUROC 0.80; CKD AUROC 0.86. Authors conclude real-world applicability requires further validation despite promise of noninvasive retinal-image-based risk prediction (nokiba2015associationbetweenophthalmological pages 1-3) 2023-07 https://doi.org/10.1167/tvst.12.7.14
Colcombe 2023 Targeted narrative review of retinal findings and cardiovascular risk Reviewed retinal disease states and imaging biomarkers including AV nicking, vessel caliber changes, OCT/OCTA biomarkers Concludes retinal findings and retinal bioimaging biomarkers may aid cardiovascular prognostication and personalized counseling; notes classic retinopathy findings such as arteriovenous nicking have been incorporated into cardiovascular/stroke risk literature, but emphasizes heterogeneity and need for validation before routine implementation (nokiba2015associationbetweenophthalmological pages 1-3) 2023-10 https://doi.org/10.3390/jpm13111564

Table: This table summarizes recent quantitative studies and reviews relevant to arteriosclerotic retinopathy, fundus arteriosclerosis, and related retinal vascular biomarkers. It highlights study design, retinal phenotype definitions, effect sizes, and links to cardiovascular outcomes or risk stratification.

Notes on evidence gaps and limitations

  • Ontology identifiers (MONDO/MeSH/ICD) for “arteriosclerotic retinopathy” were not retrievable from the accessed full texts; many studies define the condition via fundus grading rather than standardized diagnostic codes. (liu2023sexspecificassociationbetween pages 3-4, sugiura2022examinationoflarge media a2b302a2)
  • Genetic causality is not supported in the current evidence set; the phenotype appears primarily as a complex, risk-factor-driven manifestation. (iorga2024noninvasiveretinalvessel pages 5-7)
  • Several high-impact clinical guideline sources and some 2023–2024 articles were unobtainable via the toolchain in this run; thus, the report emphasizes available primary cohort studies and systematic reviews.

URLs and publication dates (as available in sources)

  • Geng et al., Front Cardiovasc Med, published 2023-02-28, https://doi.org/10.3389/fcvm.2023.1116486 (geng2023sexspecificassociationof pages 1-2)
  • Liu et al., Eur J Med Res, published 2023-11, https://doi.org/10.1186/s40001-023-01508-6 (liu2023sexspecificassociationbetween pages 3-4)
  • Dong et al., Sci Rep, published 2023-07, https://doi.org/10.1038/s41598-023-38378-1 (nokiba2015associationbetweenophthalmological pages 1-3)
  • Rusu et al., Life, published 2024-03, https://doi.org/10.3390/life14040448 (rusu2024retinalstructuraland pages 1-2)
  • Iorga et al., J Pers Med, published 2024-05, https://doi.org/10.3390/jpm14050501 (iorga2024noninvasiveretinalvessel pages 5-7)

References

  1. (nokiba2015associationbetweenophthalmological pages 1-3): Hirohiko Nokiba, Takashi Takei, Chikako Suto, and Kosaku Nitta. Association between ophthalmological changes and cardiovascular diseases in patients with chronic kidney disease undergoing hemodialysis. Journal of atherosclerosis and thrombosis, 22 12:1248-54, Dec 2015. URL: https://doi.org/10.5551/jat.30601, doi:10.5551/jat.30601. This article has 9 citations and is from a peer-reviewed journal.

  2. (sugiura2022examinationoflarge media a2b302a2): Tomonori Sugiura, Yasuaki Dohi, Yasuyuki Takagi, Takashi Yokochi, Naofumi Yoshikane, Kenji Suzuki, Takamasa Tomiishi, Takashi Nagami, Mitsunori Iwase, Hiroyuki Takase, Yoshihiro Seo, and Nobuyuki Ohte. Examination of large artery atherosclerosis could reveal small artery retinopathy in untreated middle-aged individuals. Journal of Atherosclerosis and Thrombosis, 29:11-23, Jan 2022. URL: https://doi.org/10.5551/jat.59857, doi:10.5551/jat.59857. This article has 8 citations and is from a peer-reviewed journal.

  3. (liu2023sexspecificassociationbetween pages 3-4): Chunxing Liu, Xiaolong Yang, Mengmeng Ji, Xiaowei Zhang, Xiyun Bian, Tingli Chen, Yihan Li, Xing Qi, Jianfeng Wu, Jing Wang, and Zaixiang Tang. Sex-specific association between carotid atherosclerosis and fundus arteriosclerosis in a chinese population: a retrospective cross-sectional study. European Journal of Medical Research, Nov 2023. URL: https://doi.org/10.1186/s40001-023-01508-6, doi:10.1186/s40001-023-01508-6. This article has 5 citations and is from a peer-reviewed journal.

  4. (rusu2024retinalstructuraland pages 1-2): Alexandra Cristina Rusu, Karin Ursula Horvath, Grigore Tinica, Raluca Ozana Chistol, Andra-Irina Bulgaru-Iliescu, Ecaterina Tomaziu Todosia, and Klara Brînzaniuc. Retinal structural and vascular changes in patients with coronary artery disease: a systematic review and meta-analysis. Life, 14:448, Mar 2024. URL: https://doi.org/10.3390/life14040448, doi:10.3390/life14040448. This article has 23 citations.

  5. (sugiura2022examinationoflarge pages 2-4): Tomonori Sugiura, Yasuaki Dohi, Yasuyuki Takagi, Takashi Yokochi, Naofumi Yoshikane, Kenji Suzuki, Takamasa Tomiishi, Takashi Nagami, Mitsunori Iwase, Hiroyuki Takase, Yoshihiro Seo, and Nobuyuki Ohte. Examination of large artery atherosclerosis could reveal small artery retinopathy in untreated middle-aged individuals. Journal of Atherosclerosis and Thrombosis, 29:11-23, Jan 2022. URL: https://doi.org/10.5551/jat.59857, doi:10.5551/jat.59857. This article has 8 citations and is from a peer-reviewed journal.

  6. (kaushik2007prevalenceandassociations pages 1-3): Shweta Kaushik, Ava Grace Tan, Paul Mitchell, and Jie Jin Wang. Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign. Ophthalmology, 114 1:113-20, Jan 2007. URL: https://doi.org/10.1016/j.ophtha.2006.06.046, doi:10.1016/j.ophtha.2006.06.046. This article has 37 citations and is from a highest quality peer-reviewed journal.

  7. (geng2023sexspecificassociationof pages 1-2): Ruirui Geng, Qinbei Feng, Mengmeng Ji, Yongfei Dong, Shuanshuan Xu, Chunxing Liu, Yufeng He, and Zaixiang Tang. Sex-specific association of serum uric acid trajectories with risk of incident retinal arteriosclerosis in chinese population: a population-based longitudinal study. Frontiers in Cardiovascular Medicine, Feb 2023. URL: https://doi.org/10.3389/fcvm.2023.1116486, doi:10.3389/fcvm.2023.1116486. This article has 2 citations and is from a peer-reviewed journal.

  8. (sugiura2022examinationoflarge pages 12-13): Tomonori Sugiura, Yasuaki Dohi, Yasuyuki Takagi, Takashi Yokochi, Naofumi Yoshikane, Kenji Suzuki, Takamasa Tomiishi, Takashi Nagami, Mitsunori Iwase, Hiroyuki Takase, Yoshihiro Seo, and Nobuyuki Ohte. Examination of large artery atherosclerosis could reveal small artery retinopathy in untreated middle-aged individuals. Journal of Atherosclerosis and Thrombosis, 29:11-23, Jan 2022. URL: https://doi.org/10.5551/jat.59857, doi:10.5551/jat.59857. This article has 8 citations and is from a peer-reviewed journal.

  9. (iorga2024noninvasiveretinalvessel pages 5-7): Raluca Eugenia Iorga, Damiana Costin, Răzvana Sorina Munteanu-Dănulescu, Elena Rezuș, and Andreea Dana Moraru. Non-invasive retinal vessel analysis as a predictor for cardiovascular disease. Journal of Personalized Medicine, 14:501, May 2024. URL: https://doi.org/10.3390/jpm14050501, doi:10.3390/jpm14050501. This article has 21 citations.

  10. (nokiba2015associationbetweenophthalmological pages 3-4): Hirohiko Nokiba, Takashi Takei, Chikako Suto, and Kosaku Nitta. Association between ophthalmological changes and cardiovascular diseases in patients with chronic kidney disease undergoing hemodialysis. Journal of atherosclerosis and thrombosis, 22 12:1248-54, Dec 2015. URL: https://doi.org/10.5551/jat.30601, doi:10.5551/jat.30601. This article has 9 citations and is from a peer-reviewed journal.

  11. (sugiura2022examinationoflarge pages 7-9): Tomonori Sugiura, Yasuaki Dohi, Yasuyuki Takagi, Takashi Yokochi, Naofumi Yoshikane, Kenji Suzuki, Takamasa Tomiishi, Takashi Nagami, Mitsunori Iwase, Hiroyuki Takase, Yoshihiro Seo, and Nobuyuki Ohte. Examination of large artery atherosclerosis could reveal small artery retinopathy in untreated middle-aged individuals. Journal of Atherosclerosis and Thrombosis, 29:11-23, Jan 2022. URL: https://doi.org/10.5551/jat.59857, doi:10.5551/jat.59857. This article has 8 citations and is from a peer-reviewed journal.

  12. (sugiura2022examinationoflarge pages 6-7): Tomonori Sugiura, Yasuaki Dohi, Yasuyuki Takagi, Takashi Yokochi, Naofumi Yoshikane, Kenji Suzuki, Takamasa Tomiishi, Takashi Nagami, Mitsunori Iwase, Hiroyuki Takase, Yoshihiro Seo, and Nobuyuki Ohte. Examination of large artery atherosclerosis could reveal small artery retinopathy in untreated middle-aged individuals. Journal of Atherosclerosis and Thrombosis, 29:11-23, Jan 2022. URL: https://doi.org/10.5551/jat.59857, doi:10.5551/jat.59857. This article has 8 citations and is from a peer-reviewed journal.

  13. (bisen2025retinalimagingas pages 5-8): Jay Bharatsingh Bisen, Hayden Sikora, Anushree Aneja, Sanjiv J. Shah, and Rukhsana G. Mirza. Retinal imaging as a window into cardiovascular health: towards harnessing retinal analytics for precision cardiovascular medicine. Journal of Cardiovascular Development and Disease, 12:230, Jun 2025. URL: https://doi.org/10.3390/jcdd12060230, doi:10.3390/jcdd12060230. This article has 6 citations.

  14. (sugiura2022examinationoflarge pages 1-2): Tomonori Sugiura, Yasuaki Dohi, Yasuyuki Takagi, Takashi Yokochi, Naofumi Yoshikane, Kenji Suzuki, Takamasa Tomiishi, Takashi Nagami, Mitsunori Iwase, Hiroyuki Takase, Yoshihiro Seo, and Nobuyuki Ohte. Examination of large artery atherosclerosis could reveal small artery retinopathy in untreated middle-aged individuals. Journal of Atherosclerosis and Thrombosis, 29:11-23, Jan 2022. URL: https://doi.org/10.5551/jat.59857, doi:10.5551/jat.59857. This article has 8 citations and is from a peer-reviewed journal.