TY - JOUR
T1 - Association between hypertension and retinal vascular features in ultra-widefield fundus imaging
AU - Robertson, Gavin
AU - Fleming, Alan
AU - Williams, Michelle Claire
AU - Trucco, Emanuele
AU - Quinn, Nicola
AU - Hogg, Ruth
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
AU - Northern Ireland Cohort of Longitudinal Ageing
N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
PY - 2020/1/8
Y1 - 2020/1/8
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 - Automation
KW - Blood Pressure
KW - Female
KW - Fundus Oculi
KW - Humans
KW - Hypertension/complications
KW - Image Interpretation, Computer-Assisted
KW - Longitudinal Studies
KW - Male
KW - Middle Aged
KW - Ophthalmoscopy
KW - Predictive Value of Tests
KW - Reproducibility of Results
KW - Retinal Diseases/diagnostic imaging
KW - Retinal Vessels/diagnostic imaging
KW - Retrospective Studies
U2 - 10.1136/openhrt-2019-001124
DO - 10.1136/openhrt-2019-001124
M3 - Article
C2 - 32076560
SN - 2053-3624
VL - 7
JO - Open Heart
JF - Open Heart
IS - 1
M1 - e001124
ER -