Episcleral vascular abnormalities in pulmonary arterial hypertension: clinical significance and genetic implications

Pulmonary arterial hypertension (PAH) is a disease condition characterized by pulmonary arterial remodeling, ultimately leading to right heart failure and death [1]. Although PAH primarily affects the pulmonary arteries, it also complicates with extrapulmonary manifestations [2]. Notably, ocular changes have emerged as an important area of investigation, given the unique sensitivity of the retinal microvasculature to systemic hemodynamic and oxygen-related alterations [3–6].