July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Fractal dimension of the retinal vasculature: age-related evolution in the general population and effect of cardiovascular health status
Author Affiliations & Notes
  • Sophie Lemmens
    Department of Neurosciences, KU Leuven, Leuven, Belgium
    Department of Ophthalmology, UZ Leuven, Leuven, Belgium
  • Charlien Landtmeeters
    Department of Neurosciences, KU Leuven, Leuven, Belgium
  • Reinout Peeters
    Department of Neurosciences, KU Leuven, Leuven, Belgium
  • Anne-Sophie Simons
    Department of Neurosciences, KU Leuven, Leuven, Belgium
  • Julie Vercauteren
    Department of Neurosciences, KU Leuven, Leuven, Belgium
  • Joao Barbosa-Breda
    Department of Neurosciences, KU Leuven, Leuven, Belgium
    Surgery and Physiolog (Ophthalmology Unit), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  • Karel Van Keer
    Department of Neurosciences, KU Leuven, Leuven, Belgium
    Department of Ophthalmology, UZ Leuven, Leuven, Belgium
  • Patrick De Boever
    Department of Health, VITO (Flemish Institute for Technological Research), Mol, Belgium
  • Ingeborg Stalmans
    Department of Neurosciences, KU Leuven, Leuven, Belgium
    Department of Ophthalmology, UZ Leuven, Leuven, Belgium
  • Footnotes
    Commercial Relationships   Sophie Lemmens, VITO (Flemish Institute for Technological Research) (F); Charlien Landtmeeters, None; Reinout Peeters, None; Anne-Sophie Simons, None; Julie Vercauteren, None; Joao Barbosa-Breda, None; Karel Van Keer, None; Patrick De Boever, VITO (Flemish Institute for Technological Research) (E); Ingeborg Stalmans, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6385. doi:
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      Sophie Lemmens, Charlien Landtmeeters, Reinout Peeters, Anne-Sophie Simons, Julie Vercauteren, Joao Barbosa-Breda, Karel Van Keer, Patrick De Boever, Ingeborg Stalmans; Fractal dimension of the retinal vasculature: age-related evolution in the general population and effect of cardiovascular health status. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6385.

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

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Abstract

Purpose : Little is known about the fractal dimension (Df) in the general population and only a handful studies report on its relationship with age and cardiovascular health. We performed a retrospective, observational clinical study to investigate the age-related evolution of the Df of the retinal vascular network in a large sample representative of the general population, and to determine the effect of cardiovascular health status on this vascular parameter.

Methods : A total of 890 disc-centered fundus images of 890 individuals (53% female) were collected, aiming at approximately 100 subjects in every 10-year age group between 0 and 99 years. For all participants, available information on ophthalmological and cardiovascular health status was recorded. MonaTM REVA (VITO NV, Mol, Belgium), software for semi-automated retinal vessel analysis, was used for vessel segmentation and retinal vascular fractal analysis, using the box counting method. The region of interest was the annulus between 1.5 and 4 times the radius of the optic disc, centered on the optic disc.

Results : A mean (± SD) Df of 1.399 (± 0.038) was observed. First, a significant negative correlation was noted between Df and aging (p<0.001). The mean values (± SD) of the Df per age group were 1.452 (± 0.045) in 0-9 years old, 1.421 (± 0.041) in 10-19 years, 1.400 (± 0.031) in 20-29 years, 1.395 (± 0.028) in 30-39 years, 1.395 (± 0.031) in 40-49 years, 1.393 (± 0.031) in 50-59 years, 1.388 (± 0.028) in 60-69 years, 1.388 (± 0.030) in 70-79 years, 1.382 (± 0.032) in 80-89 years and 1.365 (± 0.026) in the 90-99 years age group. Except for the very young (<20 years) and very old (>89 years) individuals, no significant differences were found in Df between the different age groups, indicating the Df is a rather robust parameter. Second, a stepwise multivariate linear regression model showed that Df is significantly correlated with age, BMI, BMI^2 and smoking, while adjusting for gender, arterial hypertension, diabetes, hypercholesterolemia, cardiovascular pathology, neurological pathology and age-related macular degeneration (AMD).

Conclusions : This study demonstrates that the retinal vasculature undergoes age-related rarefaction and that its Df is a robust parameter over a wide age range (20-89 years). Additionally, this Df is not only correlated with age, but also with BMI and smoking.

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

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