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Evaluation of the Retinal Vasculature in Hypertension and Chronic Kidney Disease in an Elderly Population of Irish Nuns.

McGowan A, Silvestri G, Moore E, Silvestri V, Patterson CC, Maxwell AP, McKay GJ - PLoS ONE (2015)

Bottom Line: Hypertension was significantly associated with a narrower central retinal arteriolar equivalent (CRAE) in a fully adjusted analysis (P = 0.002; effect size = -2.16 μm; 95% confidence intervals [CI]: -3.51, -0.81 μm).No significant associations between other retinal vascular parameters and hypertension or between any retinal vascular parameters and CKD were found.No significant associations between retinal vascular parameters and CKD were detected.

View Article: PubMed Central - PubMed

Affiliation: Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.

ABSTRACT

Background: Chronic kidney disease (CKD) and hypertension are global public health problems associated with considerable morbidity, premature mortality and attendant healthcare costs. Previous studies have highlighted that non-invasive examination of the retinal microcirculation can detect microvascular pathology that is associated with systemic disorders of the circulatory system such as hypertension. We examined the associations between retinal vessel caliber (RVC) and fractal dimension (DF), with both hypertension and CKD in elderly Irish nuns.

Methods: Data from 1233 participants in the cross-sectional observational Irish Nun Eye Study (INES) were assessed from digital photographs with a standardized protocol using computer-assisted software. Multivariate regression analyses were used to assess associations with hypertension and CKD, with adjustment for age, body mass index (BMI), refraction, fellow eye RVC, smoking, alcohol consumption, ischemic heart disease (IHD), cerebrovascular accident (CVA), diabetes and medication use.

Results: In total, 1122 (91%) participants (mean age: 76.3 [range: 56-100] years) had gradable retinal images of sufficient quality for blood vessel assessment. Hypertension was significantly associated with a narrower central retinal arteriolar equivalent (CRAE) in a fully adjusted analysis (P = 0.002; effect size = -2.16 μm; 95% confidence intervals [CI]: -3.51, -0.81 μm). No significant associations between other retinal vascular parameters and hypertension or between any retinal vascular parameters and CKD were found.

Conclusions: Individuals with hypertension have significantly narrower retinal arterioles which may afford an earlier opportunity for tailored prevention and treatment options to optimize the structure and function of the microvasculature, providing additional clinical utility. No significant associations between retinal vascular parameters and CKD were detected.

No MeSH data available.


Related in: MedlinePlus

Retinal vascular calibre measurement.Retinal arteriolar and venular calibers were summarized as central retinal arteriolar (CRAE) and the central retinal venular (CRVE) equivalent respectively from digital retinal fundus images using the Interactive Vessel Analysis software (IVAN, University of Wisconsin, US). Arterioles are in red and venules are in blue.
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pone.0136434.g001: Retinal vascular calibre measurement.Retinal arteriolar and venular calibers were summarized as central retinal arteriolar (CRAE) and the central retinal venular (CRVE) equivalent respectively from digital retinal fundus images using the Interactive Vessel Analysis software (IVAN, University of Wisconsin, US). Arterioles are in red and venules are in blue.

Mentions: Retinal arteriolar and venular calibers were measured using Interactive Vessel ANalysis software (IVAN; University of Wisconsin, Madison, WI) according to a standardized protocol for all retinal vessels located between a half and one disc diameter distance from the optic disc margin in the digitized image (Fig 1). The revised Knudston-Hubbard formula [48] was used to summarize these measurements as CRAE (Central Retinal Arteriolar Equivalent) and CRVE (Central Retinal Venular Equivalent), which represent the average caliber of the arterioles and venules in each eye examined. A single trained grader (AMG), blinded to participants characteristics, conducted all retinal measurements. Reproducibility of retinal vascular measurements was high with intra-grader reliability assessed in 200 randomly selected retinal photographs and an intra-class correlation coefficient (95% confidence interval) calculated as 0.975 (0.967–0.981) for CRAE and 0.993 (0.990–0.994) for CRVE, respectively. A high correlation between the right and left eyes in retinal vascular measurements has been reported elsewhere [49]. Data from the right eye was used and when unavailable, was replaced by the left eye.


Evaluation of the Retinal Vasculature in Hypertension and Chronic Kidney Disease in an Elderly Population of Irish Nuns.

McGowan A, Silvestri G, Moore E, Silvestri V, Patterson CC, Maxwell AP, McKay GJ - PLoS ONE (2015)

Retinal vascular calibre measurement.Retinal arteriolar and venular calibers were summarized as central retinal arteriolar (CRAE) and the central retinal venular (CRVE) equivalent respectively from digital retinal fundus images using the Interactive Vessel Analysis software (IVAN, University of Wisconsin, US). Arterioles are in red and venules are in blue.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556713&req=5

pone.0136434.g001: Retinal vascular calibre measurement.Retinal arteriolar and venular calibers were summarized as central retinal arteriolar (CRAE) and the central retinal venular (CRVE) equivalent respectively from digital retinal fundus images using the Interactive Vessel Analysis software (IVAN, University of Wisconsin, US). Arterioles are in red and venules are in blue.
Mentions: Retinal arteriolar and venular calibers were measured using Interactive Vessel ANalysis software (IVAN; University of Wisconsin, Madison, WI) according to a standardized protocol for all retinal vessels located between a half and one disc diameter distance from the optic disc margin in the digitized image (Fig 1). The revised Knudston-Hubbard formula [48] was used to summarize these measurements as CRAE (Central Retinal Arteriolar Equivalent) and CRVE (Central Retinal Venular Equivalent), which represent the average caliber of the arterioles and venules in each eye examined. A single trained grader (AMG), blinded to participants characteristics, conducted all retinal measurements. Reproducibility of retinal vascular measurements was high with intra-grader reliability assessed in 200 randomly selected retinal photographs and an intra-class correlation coefficient (95% confidence interval) calculated as 0.975 (0.967–0.981) for CRAE and 0.993 (0.990–0.994) for CRVE, respectively. A high correlation between the right and left eyes in retinal vascular measurements has been reported elsewhere [49]. Data from the right eye was used and when unavailable, was replaced by the left eye.

Bottom Line: Hypertension was significantly associated with a narrower central retinal arteriolar equivalent (CRAE) in a fully adjusted analysis (P = 0.002; effect size = -2.16 μm; 95% confidence intervals [CI]: -3.51, -0.81 μm).No significant associations between other retinal vascular parameters and hypertension or between any retinal vascular parameters and CKD were found.No significant associations between retinal vascular parameters and CKD were detected.

View Article: PubMed Central - PubMed

Affiliation: Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.

ABSTRACT

Background: Chronic kidney disease (CKD) and hypertension are global public health problems associated with considerable morbidity, premature mortality and attendant healthcare costs. Previous studies have highlighted that non-invasive examination of the retinal microcirculation can detect microvascular pathology that is associated with systemic disorders of the circulatory system such as hypertension. We examined the associations between retinal vessel caliber (RVC) and fractal dimension (DF), with both hypertension and CKD in elderly Irish nuns.

Methods: Data from 1233 participants in the cross-sectional observational Irish Nun Eye Study (INES) were assessed from digital photographs with a standardized protocol using computer-assisted software. Multivariate regression analyses were used to assess associations with hypertension and CKD, with adjustment for age, body mass index (BMI), refraction, fellow eye RVC, smoking, alcohol consumption, ischemic heart disease (IHD), cerebrovascular accident (CVA), diabetes and medication use.

Results: In total, 1122 (91%) participants (mean age: 76.3 [range: 56-100] years) had gradable retinal images of sufficient quality for blood vessel assessment. Hypertension was significantly associated with a narrower central retinal arteriolar equivalent (CRAE) in a fully adjusted analysis (P = 0.002; effect size = -2.16 μm; 95% confidence intervals [CI]: -3.51, -0.81 μm). No significant associations between other retinal vascular parameters and hypertension or between any retinal vascular parameters and CKD were found.

Conclusions: Individuals with hypertension have significantly narrower retinal arterioles which may afford an earlier opportunity for tailored prevention and treatment options to optimize the structure and function of the microvasculature, providing additional clinical utility. No significant associations between retinal vascular parameters and CKD were detected.

No MeSH data available.


Related in: MedlinePlus