The Relationship of Retinal Vessel Diameters and Fractal Dimensions with Blood Pressure and Cardiovascular Risk Factors

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2014 Sep 5

PMID 25188273

Citations 22

Authors

Pengli Zhu

Feng Huang

Fan Lin

Qiaowei Li

Yin Yuan

Zhonghai Gao

Falin Chen

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to investigate the correlation between quantitative retinal vascular parameters such as central retinal arteriolar equivalent (CRAE) and retinal vascular fractal dimension (D(f)), and cardiovascular risk factors in the Chinese Han population residing in the in islands of southeast China.

Methodology/principle Findings: In this cross-sectional study, fundus photographs were collected and semi-automated analysis software was used to analyze retinal vessel diameters and fractal dimensions. Cardiovascular risk factors such as relevant medical history, blood pressure (BP), lipids, and blood glucose data were collected. Subjects had a mean age of 51.9 ± 12.0 years and included 812 (37.4%) males and 1,357 (62.6%) females. Of the subjects, 726 (33.5%) were overweight, 226 (10.4%) were obese, 272 (12.5%) had diabetes, 738 (34.0%) had hypertension, and 1,156 (53.3%) had metabolic syndrome. After controlling for the effects of potential confounders, multivariate analyses found that age (β = 0.06, P = 0.008), sex (β = 1.33, P = 0.015), mean arterial blood pressure (β = -0.12, P<0.001), high-sensitivity C-reactive protein (β = -0.22, P = 0.008), and CRVE (β = 0.23, P<0.001) were significantly associated with CRAE. Age (β = -0.0012, P < 0.001), BP classification (prehypertension: β = -0.0075, P = 0.014; hypertension: β = -0.0131, P = 0.002), and hypertension history (β = -0.0007, P = 0.009) were significantly associated with D(f).

Conclusions/significance: D(f) exhibits a stronger association with BP than CRAE. Thus, D(f) may become a useful indicator of cardiovascular risk.

Citing Articles

Computational single fundus image restoration techniques: a review.

Zhang S, Webers C, Berendschot T Front Ophthalmol (Lausanne). 2024; 4:1332197.

PMID: 38984141 PMC: 11199880. DOI: 10.3389/fopht.2024.1332197.

NONAN GaitPrint: An IMU gait database of healthy young adults.

Wiles T, Mangalam M, Sommerfeld J, Kim S, Brink K, Charles A Sci Data. 2023; 10(1):867.

PMID: 38052819 PMC: 10698035. DOI: 10.1038/s41597-023-02704-z.

Fractal analysis of the macular region in healthy eyes using swept-source optical coherence tomography angiography.

Magesan K, Gnanaraj R, Tojjar J, Amose T, Alagorie A, Mahalingam M Graefes Arch Clin Exp Ophthalmol. 2023; 261(10):2787-2794.

PMID: 37199803 DOI: 10.1007/s00417-023-06117-x.

Association of retinal fractal dimension and vessel tortuosity with impaired renal function among healthy Chinese adults.

Wu L, Gong X, Wang W, Zhang L, Zhou J, Ming X Front Med (Lausanne). 2022; 9:925756.

PMID: 36117976 PMC: 9479094. DOI: 10.3389/fmed.2022.925756.

The Longitudinal Assessment of Vascular Parameters of the Retina and Their Correlations with Systemic Characteristics in Type 2 Diabetes-A Pilot Study.

Khan R, Saha S, Frost S, Kanagasingam Y, Raman R Vision (Basel). 2022; 6(3).

PMID: 35893762 PMC: 9326718. DOI: 10.3390/vision6030045.

References

Huang F, Zhu P, Xiao H, Lin F, Yuan Y, Gao Z . [Cardiovascular disease risk and vascular damage status in pre- and hypertension population in coastal areas of Fujian province]. Zhonghua Xin Xue Guan Bing Za Zhi. 2014; 41(10):876-81. View

Alberti K, Zimmet P, Shaw J . The metabolic syndrome--a new worldwide definition. Lancet. 2005; 366(9491):1059-62. DOI: 10.1016/S0140-6736(05)67402-8. View

Cheung C, Tay W, Mitchell P, Wang J, Hsu W, Lee M . Quantitative and qualitative retinal microvascular characteristics and blood pressure. J Hypertens. 2011; 29(7):1380-91. DOI: 10.1097/HJH.0b013e328347266c. View

Liew G, Mitchell P, Rochtchina E, Wong T, Hsu W, Lee M . Fractal analysis of retinal microvasculature and coronary heart disease mortality. Eur Heart J. 2010; 32(4):422-9. DOI: 10.1093/eurheartj/ehq431. View

Wong T, Shankar A, Klein R, Klein B, Hubbard L . Prospective cohort study of retinal vessel diameters and risk of hypertension. BMJ. 2004; 329(7457):79. PMC: 449809. DOI: 10.1136/bmj.38124.682523.55. View

Tsai A, Wong T, Lavanya R, Zhang R, Hamzah H, Tai E . Differential association of retinal arteriolar and venular caliber with diabetes and retinopathy. Diabetes Res Clin Pract. 2011; 94(2):291-8. DOI: 10.1016/j.diabres.2011.07.032. View

Knudtson M, Lee K, Hubbard L, Wong T, Klein R, Klein B . Revised formulas for summarizing retinal vessel diameters. Curr Eye Res. 2003; 27(3):143-9. DOI: 10.1076/ceyr.27.3.143.16049. View

Wang J, Liew G, Klein R, Rochtchina E, Knudtson M, Klein B . Retinal vessel diameter and cardiovascular mortality: pooled data analysis from two older populations. Eur Heart J. 2007; 28(16):1984-92. DOI: 10.1093/eurheartj/ehm221. View

Kirkutis A, Norkiene S, Griciene P, Gricius J, Yang S, Gintautas J . Prevalence of hypertension in Lithuanian mariners. Proc West Pharmacol Soc. 2005; 47:71-5. View

10.

Kawasaki R, Che Azemin M, Kumar D, Tan A, Liew G, Wong T . Fractal dimension of the retinal vasculature and risk of stroke: a nested case-control study. Neurology. 2011; 76(20):1766-7. DOI: 10.1212/WNL.0b013e31821a7d7d. View

11.

Wong T, Klein R, Nieto F, Klein B, Sharrett A, Meuer S . Retinal microvascular abnormalities and 10-year cardiovascular mortality: a population-based case-control study. Ophthalmology. 2003; 110(5):933-40. DOI: 10.1016/S0161-6420(03)00084-8. View

12.

Lim S, Cheung N, Wang J, Donaghue K, Liew G, Islam F . Retinal vascular fractal dimension and risk of early diabetic retinopathy: A prospective study of children and adolescents with type 1 diabetes. Diabetes Care. 2009; 32(11):2081-3. PMC: 2768218. DOI: 10.2337/dc09-0719. View

13.

Wong T, Kamineni A, Klein R, Sharrett A, Klein B, Siscovick D . Quantitative retinal venular caliber and risk of cardiovascular disease in older persons: the cardiovascular health study. Arch Intern Med. 2006; 166(21):2388-94. DOI: 10.1001/archinte.166.21.2388. View

14.

Ikram M, de Jong F, Vingerling J, Witteman J, Hofman A, Breteler M . Are retinal arteriolar or venular diameters associated with markers for cardiovascular disorders? The Rotterdam Study. Invest Ophthalmol Vis Sci. 2004; 45(7):2129-34. DOI: 10.1167/iovs.03-1390. View

15.

Soares Torres F, Fuchs S, Maestri M, Fuchs F, Oliveira M, Moreira L . Association between carotid intima-media thickness and retinal arteriolar and venular diameter in patients with hypertension: a cross-sectional study. Atherosclerosis. 2013; 229(1):134-8. DOI: 10.1016/j.atherosclerosis.2013.04.019. View

16.

Feig D, Kang D, Johnson R . Uric acid and cardiovascular risk. N Engl J Med. 2008; 359(17):1811-21. PMC: 2684330. DOI: 10.1056/NEJMra0800885. View

17.

Roger V, Go A, Lloyd-Jones D, Benjamin E, Berry J, Borden W . Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation. 2011; 125(1):e2-e220. PMC: 4440543. DOI: 10.1161/CIR.0b013e31823ac046. View

18.

Roy M, Klein R, Janal M . Relationship of retinal vessel caliber to cardiovascular disease and mortality in African Americans with type 1 diabetes mellitus. Arch Ophthalmol. 2012; 130(5):561-7. DOI: 10.1001/archophthalmol.2011.2725. View

19.

Basevi V, Di Mario S, Morciano C, Nonino F, Magrini N . Comment on: American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care 2011;34(Suppl. 1):S11-S61. Diabetes Care. 2011; 34(5):e53. PMC: 3114493. DOI: 10.2337/dc11-0174. View

20.

Azemin M, Kumar D, Wong T, Wang J, Mitchell P, Kawasaki R . Age-related rarefaction in the fractal dimension of retinal vessel. Neurobiol Aging. 2010; 33(1):194.e1-4. DOI: 10.1016/j.neurobiolaging.2010.04.010. View