Association between hypertension and retinal vascular features in ultra-widefield fundus imaging. Issue 1 (8th January 2020)

• Record Type: Journal Article
• Authors: Robertson, Gavin; Fleming, Alan; Williams, Michelle Claire; Trucco, Emanuele; Quinn, Nicola; Hogg, Ruth; McKay, Gareth J; Kee, Frank; Young, Ian; Pellegrini, Enrico; Newby, David E; van Beek, Edwin J R; Peto, Tunde; Dhillon, Baljean; van Hemert, Jano; MacGillivray, Thomas J
• Is Part Of: Open heart. Volume 7:Issue 1(2020)
• Publication Date: 2020-01-08
• Subjects: hypertension -- imaging and diagnostics -- microvascular disease; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Patients -- Periodicals; 616.12005
• DOI: 10.1136/openhrt-2019-001124
• Languages: English
• ISSNs: 2398-595X

Abstract

Abstract : 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.