Screening for hypertension using retinal vascular calibre in ultra-widefield fundus 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

Introduction: Changes to the retinal vasculature are associated with hypertension independently of traditional risk factors. We investigated whether measurements of retinal vascular calibre from ultra-widefield fundus imaging are associated with hypertensive status. Methods: We automatically measured a sub-set of ultra-widefield retinal fundus images from subjects enrolled in the Northern Ireland Cohort of Longitudinal Ageing (School of Medicine, Dentistry and Biomedical Sciences Ethics Committee, Queen’s University Belfast, SREC 12/23). Subjects were categorised as normotensive or hypertensive, according to thresholds on systolic/diastolic blood pressure measurement (140/90 mm Hg) averaged over two sitting blood pressure measurements in a clinical setting. Vascular calibre in the peripheral retina was measured to calculate the nasal-annular arteriole-venule ratio (NA-AVR), a novel summative parameter. Results: Left eyes were analysed from 431 subjects (age range 50–59 years; mean age of 54.5 ± 2.8 years; 239 (55.5%) females), with 148 (34.3%) subjects categorised as hypertensive. Using a two-sample t-test, arterioles were thinner (p<0.005, 95% confidence interval [CI], -0.009mm, -0.004mm) and NA-AVR was smaller (p<0.005, 95% CI, -0.08, -0.04) in subjects with hypertension. The area under a receiver operator characteristic curve of NA-AVR for hypertensive status was 0.67 (95% CI, 0.61 to 0.72). Conclusions: In this study, automated measurement of NA-AVR in ultra-widefield fundus imaging was associated with hypertension. With further development, this could become a test for undiagnosed hypertension in people attending routine eye health check-ups.
Original languageEnglish
Publication statusPublished - 24 Sep 2018
Event2018 British and Irish Hypertension Society Annual Scientific Meeting
- Cambridge, United Kingdom
Duration: 24 Sep 201824 Sep 2018

Conference

Conference2018 British and Irish Hypertension Society Annual Scientific Meeting
CountryUnited Kingdom
CityCambridge
Period24/09/201824/09/2018

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    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). Screening for hypertension using retinal vascular calibre in ultra-widefield fundus imaging. Paper presented at 2018 British and Irish Hypertension Society Annual Scientific Meeting
    , Cambridge, United Kingdom.