June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Associations between COPD and retinal vessel density, fractal dimension, and tortuosity density
Author Affiliations & Notes
  • Olivia Norah Murray
    Division of Informatics, Imaging, and Data Science, The University of Manchester Faculty of Biology Medicine and Health, Manchester, Manchester, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Timing Liu
    University College London Institute of Ophthalmology, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Yukun Zhou
    University College London Centre for Medical Image Computing, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Dominic Williamson
    University College London Institute of Ophthalmology, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Robbert Struyven
    University College London Centre for Medical Image Computing, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Siegfried Wagner
    University College London Institute of Ophthalmology, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Konstantinos Balaskas
    University College London Institute of Ophthalmology, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Mario Cortina Borja
    Great Ormond Street Institute of Child Health, University College London, London, London, United Kingdom, United Kingdom
  • Axel Petzold
    University College London Institute of Ophthalmology, London, London, United Kingdom
    Queen Square Institute of Neurology, University College London, London, UK, United Kingdom
  • Jugnoo Rahi
    Great Ormond Street Institute of Child Health, University College London, London, London, United Kingdom, United Kingdom
    Great Ormond Street Hospital for Children NHS Foundation Trust, London, London, United Kingdom, United Kingdom
  • Alastair K Denniston
    University Hospitals Birmingham, United Kingdom
    University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, United Kingdom
  • Pearse Keane
    University College London Institute of Ophthalmology, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Olivia Murray None; Timing Liu None; Yukun Zhou None; Dominic Williamson None; Robbert Struyven None; Siegfried Wagner None; Konstantinos Balaskas None; Mario Cortina Borja None; Axel Petzold Novartis, Code C (Consultant/Contractor), Heidelberg Engineering, Roche, Code R (Recipient); Jugnoo Rahi None; Alastair Denniston None; Pearse Keane Apellis, Code C (Consultant/Contractor), Allergan, Topcon, Heidelberg Engineering, Novartis, Roche, Bayer, Code F (Financial Support), Big Picture Medical, Code I (Personal Financial Interest)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 249. doi:
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      Olivia Norah Murray, Timing Liu, Yukun Zhou, Dominic Williamson, Robbert Struyven, Siegfried Wagner, Konstantinos Balaskas, Mario Cortina Borja, Axel Petzold, Jugnoo Rahi, Alastair K Denniston, Pearse Keane; Associations between COPD and retinal vessel density, fractal dimension, and tortuosity density. Invest. Ophthalmol. Vis. Sci. 2023;64(8):249.

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

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Abstract

Purpose :
Chronic obstructive pulmonary disease (COPD), characterized by airflow obstruction and inflammation, is a progressive respiratory disorder encompassing chronic bronchitis, chronic respiratory failure and emphysema. COPD is a leading cause of morbidity and mortality worldwide, and is rarely reversible. Previous studies have shown a link between COPD related hypoxemia and a decrease in retinal vessel density. The purpose of this study was to determine whether associations between COPD and deep-learning extracted retinal vessel features, namely retinal vessel density (VD), fractal dimension (FD), and tortuosity density (TD), could be observed in a large cohort.

Methods : This was a cross-sectional analysis of data from the AlzEye study, a retrospective cohort of 154,830 patients aged 40 years and over who had retinal imaging at Moorfields Eye Hospital between January 2008 and April 2018. VD, FD, and TD of the retinal vasculature were extracted from macular-centered color fundus photographs using an in-house developed deep-learning algorithm called AutoMorph. Data were curated based on image quality and missing features. To assess the relationship between retinal vessel features and COPD, values for VD, FD and TD were calculated for all patients (N case=4392, N controls=86699). Wilcoxon test statistics were computed, and a linear regression was conducted, controlling for age, ethnicity, sex, diabetes melitus, and hypertension.

Results :
Overall, patients with COPD had a lower VD (mean 0.0656, SD 0.0131), lower FD (mean 1.4583, SD 0.0469), and higher TD (mean 0.7066, SD 0.0341) compared to those without COPD (mean VD: 0.0678, SD 0.0143; mean FD: 1.4717, SD 0.0526; mean TD :0.6988, SD 0.0327). All differences were statistically significant as determined by Wilcoxon tests (p-values 9.96e-31, 2.07e-90, and 3.76e-50, respectively). The association between VD, FD, and TD in COPD patients is still observed in linear regression, controlling for age, sex, ethnicity, diabetes melitus, and hypertension (p-values 1.9e-32, 9.13e-13, 6.46e-04, respectively).

Conclusions : This study provides strong evidence of associations between VD, FD, and TD of the retinal vasculature and COPD. Whether retinal imaging could act as an adjunct outcome measure for disease progression in COPD warrants further investigation.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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