TY - JOUR
T1 - A spectrum of retinal vasculature measures and coronary artery disease
AU - Wang, Sarah
AU - Mitchell, Paul
AU - Liew, Gerald
AU - Wong, Tien Yin
AU - Phan, Kevin
AU - Thiagalingam, Aravinda
AU - Joachim, Nichole
AU - Burlutsky, George
AU - Gopinath, Bamini
PY - 2018/1
Y1 - 2018/1
N2 - Background and aims We aimed to comprehensively describe a spectrum of retinal vessel measures including fractal dimension (D
f) and their associations with indices of coronary artery disease (CAD) extent and severity, as well as hypertension and diabetes. Methods The Australian Heart Eye Study (AHES) is an observational study that surveyed 1680 participants presenting to a tertiary referral hospital for the evaluation of potential CAD by coronary angiography. A range of newer retinal vessel geometric measures (D
f, curvature tortuosity, and branching angle) were quantified from retinal photographs using semi-automated software, the Singapore ‘I’ Vessel Assessment (SIVA) tool. A combined retinal score was constructed, aiming to assess the joint effect of multiple retinal vessel parameters on CAD, comprising of those variables that were most strongly significant in multivariate analysis - D
f, arteriolar curvature tortuosity, and retinal arteriolar calibre. CAD was objectively quantified using a range of measures obtained from coronary angiography. Results A total of 1187 participants had complete data on retinal vessel measurements and coronary vessel evaluation. Retinal vascular D
f and curvature tortuosity decreased with increasing age; women had significantly lower D
f than men (p<0.003). Straighter retinal vessels were associated with CAD extent and Gensini scores in multivariable analysis (p<0.02). Accounting for media opacity by sub-group analysis in pseudophakic patients, the combined retinal score was associated with stenosis greater than 50% in any coronary artery segment (vessel score) and obstructive coronary stenosis in all three main coronary arteries (segment score) (p = 0.01). Lower D
f and narrower arteriolar branching angle were associated with CAD vessel score (p<0.03). In sex-stratified multivariate analyses, straighter arterioles were associated with greater odds of CAD in men, and narrower venular branching angle was associated with CAD in women. Conclusions A range of retinal vessel measures were associated with CAD extent and severity. A sparser retinal microvascular network (smaller D
f) was associated with older age and female gender. After accounting for the impact of media opacity, retinal vessel measures were associated with more diffuse and severe CAD.
AB - Background and aims We aimed to comprehensively describe a spectrum of retinal vessel measures including fractal dimension (D
f) and their associations with indices of coronary artery disease (CAD) extent and severity, as well as hypertension and diabetes. Methods The Australian Heart Eye Study (AHES) is an observational study that surveyed 1680 participants presenting to a tertiary referral hospital for the evaluation of potential CAD by coronary angiography. A range of newer retinal vessel geometric measures (D
f, curvature tortuosity, and branching angle) were quantified from retinal photographs using semi-automated software, the Singapore ‘I’ Vessel Assessment (SIVA) tool. A combined retinal score was constructed, aiming to assess the joint effect of multiple retinal vessel parameters on CAD, comprising of those variables that were most strongly significant in multivariate analysis - D
f, arteriolar curvature tortuosity, and retinal arteriolar calibre. CAD was objectively quantified using a range of measures obtained from coronary angiography. Results A total of 1187 participants had complete data on retinal vessel measurements and coronary vessel evaluation. Retinal vascular D
f and curvature tortuosity decreased with increasing age; women had significantly lower D
f than men (p<0.003). Straighter retinal vessels were associated with CAD extent and Gensini scores in multivariable analysis (p<0.02). Accounting for media opacity by sub-group analysis in pseudophakic patients, the combined retinal score was associated with stenosis greater than 50% in any coronary artery segment (vessel score) and obstructive coronary stenosis in all three main coronary arteries (segment score) (p = 0.01). Lower D
f and narrower arteriolar branching angle were associated with CAD vessel score (p<0.03). In sex-stratified multivariate analyses, straighter arterioles were associated with greater odds of CAD in men, and narrower venular branching angle was associated with CAD in women. Conclusions A range of retinal vessel measures were associated with CAD extent and severity. A sparser retinal microvascular network (smaller D
f) was associated with older age and female gender. After accounting for the impact of media opacity, retinal vessel measures were associated with more diffuse and severe CAD.
KW - fractal dimension
KW - retinal microvasculature
KW - retinal vessel calibre
KW - coronary artery disease
KW - Gensini score
KW - extent score
KW - Australian heart eye study
UR - http://www.scopus.com/inward/record.url?scp=85031503715&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2017.10.008
DO - 10.1016/j.atherosclerosis.2017.10.008
M3 - Article
C2 - 29050745
SN - 0021-9150
VL - 268
SP - 215
EP - 224
JO - Atherosclerosis
JF - Atherosclerosis
ER -