Classification of hypertension using nasal annular arteriole-venule ratio in ultra-widefield ophthalmic imaging

Gavin Robertson, Tunde Peto, Edwin Jr van Beek, Alan Fleming, Jano van Hemert, Michelle C Williams, Emanuele Trucco, Nicola Quinn, Ruth Hogg, Gareth McKay, Enrico Pellegrini, David E Newby, Bal Dillon, Frank Kee, Ian Young, Thomas Macgillivray

Research output: Contribution to conferencePaper

Abstract

Fundus images from the left eyes of 440 subjects aged 50-59 years enrolled in the Northern Ireland Cohort of Longitudinal Ageing were analyzed. Subjects were categorized as normotensive or hypertensive, according to thresholds on systolic/diastolic blood pressure measurement (140/90 mm Hg) averaged over two sitting measurements in a clinical setting. A fully automatic system to analyze each image used conventional and deep neural network machine learning techniques to locate retinal landmarks and detect, classify and measure retinal vessels. From this data, a measure of the arteriolar-venular ratio (AVR) in the peripheral retina was calculated. Semi-automatic analysis was also performed. Results are presented in Table 1. Subjects had mean age of 54.6 ± 2.9 years; 56.1% (247 of 440) females, with 34.3% (151 of 440) subjects categorized as hypertensive. Narrower arterioles and smaller AVR were observed in subjects with hypertension. This was also observed in fully-automated analysis, however 4% (17 of 440) subjects failed to be processed by the system. In fully-automated analysis the area under a receiver operator characteristic curve of AVR for hypertensive status was 0.69 (95% CI, 0.63 to 0.74). Table 1 - Results for semi-automated and automated analysis of retinal vessel parameters. *p<0.005 Automated measurement of AVR in ultra-widefield fundus imaging was associated with hypertension. With further development, such as evaluation against diagnosis of hypertension obtained from ambulatory blood pressure monitoring clinics, this system could become a test for undiagnosed hypertension in people attending routine eye health check-ups.
Original languageEnglish
Publication statusPublished - 06 Sep 2018
EventJoint Hypertension 2018 Scientific Sessions - Chicago, United Kingdom
Duration: 06 Sep 201806 Sep 2018

Conference

ConferenceJoint Hypertension 2018 Scientific Sessions
CountryUnited Kingdom
CityChicago
Period06/09/201806/09/2018

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  • Cite this

    Robertson, G., Peto, T., van Beek, E. J., Fleming, A., van Hemert, J., Williams, M. C., Trucco, E., Quinn, N., Hogg, R., McKay, G., Pellegrini, E., Newby, D. E., Dillon, B., Kee, F., Young, I., & Macgillivray, T. (2018). Classification of hypertension using nasal annular arteriole-venule ratio in ultra-widefield ophthalmic imaging. Paper presented at Joint Hypertension 2018 Scientific Sessions, Chicago, United Kingdom.