作为新的独立预测因子，视网膜血管迂曲度在心血管疾病发生和预后中的重要性已经引起广泛关注。在心血管疾病的多种危险因素和早期阶段，机体可能处于缺氧、炎症和血液成分异常等病理状态。这些状态导致内皮细胞功能障碍，进而增大血管内血液流动的剪切力。这种较大的剪切应力、伴随着血管结构重塑以及机械稳定性的丧失，可能是导致视网膜血管迂曲度变化的机制。近年来，临床研究探索了视网膜血管迂曲度与心血管患病或发病风险及其危险因素之间的关联，结果显示视网膜静脉迂曲度增加与收缩压增高、身体质量指数增加、长期高血压密切相关；视网膜静脉迂曲度增加也可能是糖尿病微血管损伤的早期指标，与较高的2型糖尿病患病风险相关，在预测糖尿病性视网膜病变的发生、发展和严重程度方面具有重要价值；视网膜动脉迂曲度与甘油三酯、总胆固醇和低密度脂蛋白水平呈正相关。视网膜血管分析在心血管风险预防和预后中具有重要的临床实践价值。通过评估视网膜血管迂曲度的变化，医师可以获得心血管疾病的早期预警和风险评估信息；视网膜血管分析可以辅助临床医师制定个体化的治疗方案，监测治疗效果，并评估患者的预后情况。本文中笔者对视网膜血管迂曲度变化的机制、临床相关性及其在心血管疾病早期诊断和管理中的应用价值进行综述。

As a new independent predictor, the importance of retinal vascular tortuosity in the occurrence and prognosis of cardiovascular diseases has attracted widespread attention. In various risk factors and early stages of cardiovascular disease, the body may be in pathological states such as hypoxia, inflammation, and abnormal blood composition. These states lead to endothelial cell dysfunction, which in turn increases the shear force of blood flow in the blood vessels. This large shear stress, accompanied by vascular structural remodeling and loss of mechanical stability, may be the mechanism leading to changes in retinal vascular tortuosity. In recent years, the association between retinal vein tortuosity and cardiovascular disease or disease risk and risk factors have been explored in a quantify of clinical trials, which shows that an increase in retinal vein tortuosity is closely related to increased systolic blood pressure, increased body mass index, and long-term hypertension. The increase of retinal vein tortuosity may also be an early indicator of microvascular injury in diabetes, which is related to the higher risk of type 2 diabetes, and has important value in predicting the occurrence, development and severity of diabetes retinopathy. The tortuosity of retinal arteries is positively correlated with levels of triglycerides, total cholesterol, and low-density lipoprotein. Evaluating the changes of retinal vascular tortuosity has important clinical practice value in cardiovascular risk prevention and prognosis, such as obtaining early warning and risk assessment information for cardiovascular diseases for physican. Retinal vascular analysis can assist clinicians in developing personalized treatment plans, monitoring treatment outcomes, and evaluating patient prognosis. The mechanism, clinical relevance, and application value of retinal vascular tortuosity changes in early diagnosis and management of cardiovascular diseases were reviewed in this paper.