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Edouard Koch, David Rosenbaumm, Xavier Girerd, Florence Rossant, Michel Paques; Parietal morphometry of retinal arterioles in health and hypertension using adaptive optics. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6058.
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© ARVO (1962-2015); The Authors (2016-present)
Morphological changes affecting the wall of small retinal arteries are recognized surrogates of end-organ damage secondary to aging and/or arterial hypertension. However, direct observation of the microvascular wall is not feasible with routine imaging techniques. We report here the quantitative analysis of the structure of retinal arterioles (~ 50-150 µm diameter) using adaptive optics (AO) near infrared (NIR) imaging (rtx1 camera; ImagineEyes, France) in normo and hypertensive humans.
From OA images, the wall-to-lumen ratio (WLR) was calculated using a dedicated software. We compared the WLR between a control group (n = 20; 30.2 ± 6 years) and a group of hypertensive subjects (n = 30, 48.1 ± 13 years). Focal lesions (arteriolar narrowing and arteriovenous nickings) were also analyzed. These data were compared to the carotid intima-media thickness (IMT).
The WLR was significantly higher in the hypertensive group than in controls (0.35 ± 0.071 vs 0.26 ± 0.035, respectively; p=0.017) after correcting for age. The WLR of retinal arterioles was also positively correlated to current arterial pressure (r=0.36; p=0.03) and to IMT (p=0.028). Arteriolar narrowing, but not arteriovenous nickings, showed locally increased WLR. Follow-up of patients under hypotensive treatment (n=7; mean follow-up 6 months) could document progressive vasodilation in two.
Past history of arterial hypertension and current arterial pressure are both associated with increased WLR. Arteriovenous narrowing and arteriovenous nicking show distinct parietal abnormalities and hence are probably due to distinct pathological processes. Thickening of large and small arteries are correlated, suggesting some degree of parallelism of the evolution of macro and microcirculatory damage. We conclude that AO imaging enables to phenotype the microcirculation with an unprecedented precision and may improve the understanding and the management of arterial hypertension.
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