July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Higher retinal microvascular fractal dimensions are associated with lower albuminuria in a subset of the UK Biobank population.
Author Affiliations & Notes
  • Euan Neil Paterson
    Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
  • Chris Cardwell
    Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
  • Tom MacGillivray
    The VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
  • Ruth Esther Hogg
    Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
  • Bernadette McGuinness
    Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
  • Praveen Patel
    Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
  • Alex Doney
    School of Medicine, University of Dundee, United Kingdom
  • Emanuele Trucco
    School of Science and Engineering, University of Dundee, United Kingdom
  • Alexander Peter Maxwell
    Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
  • Gareth McKay
    Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
  • Footnotes
    Commercial Relationships   Euan Paterson, None; Chris Cardwell, None; Tom MacGillivray, None; Ruth Hogg, None; Bernadette McGuinness, None; Praveen Patel, None; Alex Doney, None; Emanuele Trucco, None; Alexander Maxwell, None; Gareth McKay, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4311. doi:https://doi.org/
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      Euan Neil Paterson, Chris Cardwell, Tom MacGillivray, Ruth Esther Hogg, Bernadette McGuinness, Praveen Patel, Alex Doney, Emanuele Trucco, Alexander Peter Maxwell, Gareth McKay; Higher retinal microvascular fractal dimensions are associated with lower albuminuria in a subset of the UK Biobank population.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4311. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Chronic kidney disease (CKD) is forecast to become the fifth leading cause of death globally by 2040. Retinal microvascular changes resulting from systemic vascular remodeling have been reported in association with CKD and may improve stratification of risk. We assessed associations between retinal microvascular parameters and urinary albumin-to-creatinine ratio (ACR).

Methods : A case-control study was undertaken in a subset of the UK Biobank (UKBB) population. Cases had an ACR ≥ 3mg/mmol, controls had an ACR < 3mg/mmol and were matched for age, gender and ethnicity. Macula centered fundus images were analyzed using the semi-automated software Vessel Assessment and Measurement Platform for Images of the REtina (VAMPIRE). Logistic regression models were constructed to assess associations between retinal microvascular parameters and ACR status. Fully adjusted models included age, gender, ethnicity, systolic blood pressure, diagnosis of diabetes, smoking status and fellow vessel caliber for models including arteriolar and venular caliber.

Results : In this interim analysis of 930 participants (453 cases, 477 controls), the mean age was 58 years (standard deviation [SD] 8) for cases and 59 (SD 8) for controls; 57% of cases and 53% of controls were female. Diabetes was present in 18% of cases and 9% of controls. In models adjusted for confounding variables, higher fractal dimension (FD) was significantly associated with reduced risk of albuminuria for both arterioles (odds ratio [OR] 0.06, 95% confidence interval [CI] 0.01, 0.38) and venules (OR 0.05, CI <0.01, 0.44). Retinal microvascular caliber and tortuosity were not significantly associated with albuminuria.

Conclusions : Higher FDs (denser retinal arteriolar and venular branching patterns) are associated with reduced cross-sectional risk of albuminuria in the subset of the UKBB population considered. Given the metabolic demands and hemodynamic principles governing vascular branching, altered retinal microvascular FDs may reflect metabolic disturbances and vascular calcification in CKD.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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