Background. The retinal microvasculature reflects systemic vascular health and may serve as a non-invasive marker of cardiovascular risk. This study explores the diagnostic significance of retinal vascular signs in assessing cardiovascular risk in military personnel compared to civilian controls. Objective. To evaluate the prevalence and diagnostic relevance of retinal fundus abnormalities in individuals with varying levels of cardiovascular risk, particularly among active-duty and recently discharged military personnel. Methods. A total of 391 individuals were examined, including 287 military-affiliated subjects and 104 civilian controls. Participants underwent comprehensive clinical and ophthalmological evaluation. Retinal images were obtained using non-mydriatic fundus cameras and analyzed for five key vascular signs: venular dilation, arteriolar narrowing, reduced arterio-venous ratio (AVR < 0,66), vascular tortuosity, and vessel caliber asymmetry. Statistical analysis included group comparisons and frequency analysis across clinical subgroups. Results. Retinal abnormalities were significantly more frequent in military participants with hypertension, ischemic heart disease, or carotid atherosclerosis. AVR < 0,66 and increased vascular tortuosity were the most common signs in these groups. Even in individuals with risk factors but no diagnosed pathology, military personnel exhibited a higher prevalence of microvascular changes compared to civilians. Conclusion. Fundus-based vascular signs, especially reduced AVR and tortuosity, are valuable for early identification of cardiovascular risk. Retinal imaging may enhance non-invasive screening strategies, particularly in high-stress populations such as military personnel.

Retinal microvasculature, Cardiovascular risk, Military health, Fundus photography

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