Abstract
Accurate risk stratification of ischemic heart disease (IHD) remains pivotal for mitigating associated global health burdens. Optical theranostics, combining imaging and therapeutic capabilities through light-based technologies, has emerged as a transformative strategy for IHD management. Advanced modalities mainly including optical coherence tomography, near-infrared fluorescence imaging, and photoacoustic imaging enable high-resolution visualization of coronary anatomy, myocardial perfusion, and molecular biomarkers. These modalities complement traditional cardiovascular imaging by providing real-time functional and molecular data with enhanced spatial resolution. Concurrently, phototherapy strategies such as image-guided photodynamic and photothermal therapies show therapeutic potential in preclinical studies. Integrated theranostic platforms now operationalize closed-loop workflows, where diagnostic imaging directly informs therapeutic parameters and monitors treatment response. While challenges persist in clinical translation-including tissue penetration limitations and safety optimization-ongoing developments in contrast agents, device miniaturization, and multimodal integration are accelerating practical applications. This review examines current progress in optical theranostics for IHD, analyzing technical principles, preclinical/clinical implementations, and translational barriers to optimize cardiovascular care through light-based technologies.