TY - JOUR
T1 - Association between Hypertension and Retinal Vascular Features in Ultra-Widefield Fundus Imaging
AU - Robertson, Gavin
AU - Fleming, Alan
AU - Williams, Michelle C.
AU - Trucco, Manuel
AU - Quinn, Nicola B.
AU - Hogg, Ruth E.
AU - McKay, Gareth J.
AU - Kee, Frank
AU - Young, Ian
AU - Pellegrini, Enrico
AU - Newby, David E.
AU - van Beek, Edwin J. R.
AU - Peto, Tunde
AU - Dhillon, Baljean
AU - van Hemert, Jano
AU - MacGillivray, Thomas J.
N1 - SINAPSE (Scottish Image Network: A Platform for Scientific Excellence) Knowledge Exchange Programme Innovate UK Knowledge Transfer Partnership (1011973)
PY - 2020/2
Y1 - 2020/2
N2 - Objective: Changes to the retinal vasculature are known to be associated with hypertension independently of traditional risk factors. We investigated whether measurements of retinal vascular calibre from ultra-widefield fundus imaging were associated with hypertensive status.Methods: We retrospectively collected and semiautomatically measured ultra-widefield retinal fundus images from a subset of participants enrolled in an ongoing population study of ageing, categorised as normotensive or hypertensive according to thresholds on systolic/diastolic blood pressure (140/90 mm Hg) measured in a clinical setting. Vascular calibre in the peripheral retina was measured to calculate the nasal-annular arteriole:venule ratio (NA-AVR), a novel combined parameter.Results: Left and right eyes were analysed from 440 participants (aged 50-59 years, mean age of 54.6±2.9 years, 247, 56.1% women), including 151 (34.3%) categorised as hypertensive. Arterioles were thinner and the NA-AVR was smaller in people with hypertension. The area under the receiver operating characteristic curve of NA-AVR for hypertensive status was 0.73 (95% CI 0.68 to 0.78) using measurements from left eyes, while for right eyes, it was 0.64 (95% CI 0.59 to 0.70), representing evidence of a statistically significant difference between the eyes (p=0.020).Conclusions: Semiautomated measurements of NA-AVR in ultra-widefield fundus imaging were associated with hypertension. With further development, this may help screen people attending routine eye health check-ups for high blood pressure. These individuals may then follow a care pathway for suspected hypertension. Our results showed differences between left and right eyes, highlighting the importance of investigating both eyes of a patient.
AB - Objective: Changes to the retinal vasculature are known to be associated with hypertension independently of traditional risk factors. We investigated whether measurements of retinal vascular calibre from ultra-widefield fundus imaging were associated with hypertensive status.Methods: We retrospectively collected and semiautomatically measured ultra-widefield retinal fundus images from a subset of participants enrolled in an ongoing population study of ageing, categorised as normotensive or hypertensive according to thresholds on systolic/diastolic blood pressure (140/90 mm Hg) measured in a clinical setting. Vascular calibre in the peripheral retina was measured to calculate the nasal-annular arteriole:venule ratio (NA-AVR), a novel combined parameter.Results: Left and right eyes were analysed from 440 participants (aged 50-59 years, mean age of 54.6±2.9 years, 247, 56.1% women), including 151 (34.3%) categorised as hypertensive. Arterioles were thinner and the NA-AVR was smaller in people with hypertension. The area under the receiver operating characteristic curve of NA-AVR for hypertensive status was 0.73 (95% CI 0.68 to 0.78) using measurements from left eyes, while for right eyes, it was 0.64 (95% CI 0.59 to 0.70), representing evidence of a statistically significant difference between the eyes (p=0.020).Conclusions: Semiautomated measurements of NA-AVR in ultra-widefield fundus imaging were associated with hypertension. With further development, this may help screen people attending routine eye health check-ups for high blood pressure. These individuals may then follow a care pathway for suspected hypertension. Our results showed differences between left and right eyes, highlighting the importance of investigating both eyes of a patient.
KW - hypertension
KW - imaging and diagnostics
KW - microvascular disease
UR - http://www.scopus.com/inward/record.url?scp=85078337683&partnerID=8YFLogxK
U2 - 10.1136/openhrt-2019-001124
DO - 10.1136/openhrt-2019-001124
M3 - Article
C2 - 32076560
SN - 2053-3624
VL - 7
SP - 1
EP - 7
JO - Open Heart
JF - Open Heart
IS - 1
M1 - e001124
ER -