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Christian French, Rebekka Heitmar; Do Static Retinal Vessel Diameters Compliment Cardiovascular Risk Calculations?. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4266.
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© ARVO (1962-2015); The Authors (2016-present)
Online cardiovascular risk calculators are freely available to input known health metrics and determine the likelihood of developing a cardiovascular incident in the future. Static retinal vessel measurements are known to change as a result of cardiovascular disease. A cross-sectional study was performed to establish whether vessel calibre compliments these risk calculations.
263 subjects were enrolled from routine optometric practice in the UK. As well as a comprehensive eye examination (including refraction and fundus examination), OCT and fundus photographs were acquired, as well as blood pressure. A full history of general health, family history and lifestyle questions (including smoking status, diet and exercise) were also collected. Red-free, 50-degree, optic nerve head centred photographs were analysed using semi-automated retinal analysis software. Cardiovascular risk was calculated with the Mayo Clinic's online 30-year risk calculator.
Overall average age was 58.5 years (range: 16-93), males (n=104) 58.8 (SD) and for females (n=159) 58.3 (SD). BMI ranged from 17.6 to 37.3, with male and female averages of 26.2 and 24.6. Mean 30-year cardiovascular risk was 27.5%, and higher in men (Males: 36.3%; Females: 22.1%; p=<0.001). The was no gender difference in retinal vessel calibres (CRAE and CRVE (p=<0.001)). In univariate analysis however, reduced CRAE correlated with increased 30-year risk (R=-0.26; p=0.004), in females only. BMI was linked with increased 30-year risk and CRVE (R=0.52 (p=<0.001); R=0.19 (p=0.017) respectively). In a stepwise forward multiple regression model significance was retained for BMI and age in men only.
Whilst there are multiple relationships between retinal vessel calibres and individual cardiovascular risk factors (BMI, age, gender, etc.) this relationship is lost in some multivariate models accounting for these risk factors. Nonetheless, the present study highlights the value of retinal vessel calibres for their potential to refine existing cardiovascular risk stratification and how individual risk factors are strongly linked to vessel calibre changes which can potentially impact on the development of future ocular and systemic vascular pathology.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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