Association between Hypertension and Retinal Vascular Features in Ultra-Widefield Fundus Imaging

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 - https://www.scopus.com/pages/publications/85078337683

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 -