Association between hypertension and retinal vascular features in ultra-widefield fundus imaging

Northern Ireland Cohort of Longitudinal Ageing

doi:10.1136/openhrt-2019-001124

Association between hypertension and retinal vascular features in ultra-widefield fundus imaging

Northern Ireland Cohort of Longitudinal Ageing

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

70 Downloads (Pure)

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.

Original language	English
Article number	e001124
Number of pages	7
Journal	Open Heart
Volume	7
Issue number	1
DOIs	https://doi.org/10.1136/openhrt-2019-001124
Publication status	Published - 08 Jan 2020

Keywords

Automation
Blood Pressure
Female
Fundus Oculi
Humans
Hypertension/complications
Image Interpretation, Computer-Assisted
Longitudinal Studies
Male
Middle Aged
Ophthalmoscopy
Predictive Value of Tests
Reproducibility of Results
Retinal Diseases/diagnostic imaging
Retinal Vessels/diagnostic imaging
Retrospective Studies

Access to Document

10.1136/openhrt-2019-001124Licence: CC BY

Association between hypertension and retinal vascular features in ultrawidefield fundus imaging
Copyright 2019 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 1.05 MBLicence: CC BY

Cite this

@article{2170893810d74bd9b9a1092e6a574dc3,

title = "Association between hypertension and retinal vascular features in ultra-widefield fundus imaging",

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.",

keywords = "Automation, Blood Pressure, Female, Fundus Oculi, Humans, Hypertension/complications, Image Interpretation, Computer-Assisted, Longitudinal Studies, Male, Middle Aged, Ophthalmoscopy, Predictive Value of Tests, Reproducibility of Results, Retinal Diseases/diagnostic imaging, Retinal Vessels/diagnostic imaging, Retrospective Studies",

author = "Gavin Robertson and Alan Fleming and Williams, {Michelle Claire} and Emanuele Trucco and Nicola Quinn and Ruth Hogg and McKay, {Gareth J} and Frank Kee and Ian Young and Enrico Pellegrini and Newby, {David E} and {van Beek}, {Edwin J R} and Tunde Peto and Baljean Dhillon and {van Hemert}, Jano and MacGillivray, {Thomas J} and {Northern Ireland Cohort of Longitudinal Ageing}",

note = "{\textcopyright} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.",

year = "2020",

month = jan,

day = "8",

doi = "10.1136/openhrt-2019-001124",

language = "English",

volume = "7",

journal = "Open Heart",

issn = "2053-3624",

publisher = "BMJ Publishing Group",

number = "1",

}

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 -

Association between hypertension and retinal vascular features in ultra-widefield fundus imaging

Abstract

Keywords

Access to Document

Fingerprint

Cite this