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      Longitudinal associations of retinal vessel morphology with intraocular pressure and blood pressure at follow‐up visit—Findings from a Danish eye and vision cohort, Project FOREVER

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          Abstract

          Purpose

          To characterise the retinal vasculometry of a Danish eye and vision cohort and examine associations with systolic blood pressure (BP), diastolic BP, mean arterial BP, and intraocular pressure (IOP).

          Design

          Longitudinal study.

          Methods

          The retinal vasculature of fundus images from the FOREVER (Finding Ophthalmic Risks and Evaluating the Value of Eye exams and their predictive Reliability) cohort was analysed using a fully automated image analysis program. Longitudinal associations of retinal vessel morphology at follow‐up visit with IOP (baseline and follow‐up) and BP (follow‐up) were examined using multilevel linear regression models adjusting for age, sex and retinal vasculometry at baseline as fixed effects and person as random effect. Width measurements were additionally adjusted for the spherical equivalent.

          Results

          A total of 2089 subjects (62% female) with a mean age of 61 (standard deviation 8) years and a mean follow‐up period of 4.1 years (SD 0.6 years) were included. The mean arteriolar diameter was approximately 20% thinner than the mean venular diameter, and venules were about 21%–23% less tortuous than arterioles. BP at follow‐up was associated with decreased arteriolar diameter from baseline to follow‐up. After adjusting for baseline IOP, IOP at follow‐up was associated with increased arteriolar tortuosity above baseline (0.59%, 95% CI 0.08–1.10, p‐value 0.024).

          Conclusion

          In a Danish eye and vision cohort, variations in BP and alterations in IOP over time were associated with changes in the width and tortuosity of retinal vessels. Our findings contribute novel insights into retinal vascular alterations over time.

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          Most cited references35

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          The retina as a window to the brain-from eye research to CNS disorders.

          Philosophers defined the eye as a window to the soul long before scientists addressed this cliché to determine its scientific basis and clinical relevance. Anatomically and developmentally, the retina is known as an extension of the CNS; it consists of retinal ganglion cells, the axons of which form the optic nerve, whose fibres are, in effect, CNS axons. The eye has unique physical structures and a local array of surface molecules and cytokines, and is host to specialized immune responses similar to those in the brain and spinal cord. Several well-defined neurodegenerative conditions that affect the brain and spinal cord have manifestations in the eye, and ocular symptoms often precede conventional diagnosis of such CNS disorders. Furthermore, various eye-specific pathologies share characteristics of other CNS pathologies. In this Review, we summarize data that support examination of the eye as a noninvasive approach to the diagnosis of select CNS diseases, and the use of the eye as a valuable model to study the CNS. Translation of eye research to CNS disease, and deciphering the role of immune cells in these two systems, could improve our understanding and, potentially, the treatment of neurodegenerative disorders.
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            • Record: found
            • Abstract: not found
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            Hypertensive retinopathy.

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              Retinal vascular tortuosity, blood pressure, and cardiovascular risk factors.

              To examine the relationship of retinal vascular tortuosity to age, blood pressure, and other cardiovascular risk factors. Population-based, cross-sectional study. A total of 3280 participants aged 40 to 80 years from the Singapore Malay Eye Study (78.7% response rate). Retinal arteriolar and venular (vascular) tortuosity were quantitatively measured from fundus images using a computer-assisted program. Retinal vascular tortuosity was defined as the integral of the curvature square along the path of the vessel, normalized by the total path length. Data on blood pressure and major cardiovascular disease (CVD) risk factors were collected from all participants. Retinal arteriolar and venular tortuosity. A total of 2915 participants contributed data to this study. The mean (standard deviation) and median were 2.99 (1.40) and 2.73 for retinal arteriolar tortuosity (×10(4)), and 4.64 (2.39) and 4.19 for retinal venular tortuosity (×10(4)), respectively. Retinal venules were significantly more tortuous than retinal arterioles (P<0.001). In multivariable-adjusted linear regression models, less arteriolar tortuosity was independently associated with older age, higher blood pressure, higher body mass index (BMI), and narrower retinal arteriolar caliber (all P<0.05); greater venular tortuosity was independently associated with younger age, higher blood pressure, lower high-density lipoprotein (HDL) cholesterol level, and wider retinal venular caliber (all P<0.05). Retinal arteriolar tortuosity was associated with older age and higher levels of blood pressure and BMI, whereas venular tortuosity was also associated with lower HDL level. The quantitative assessment of retinal vascular tortuosity from retinal images may provide further information regarding effects of cardiovascular risk factors on the retinal vasculature. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                miriamk@sund.ku.dk
                Journal
                Acta Ophthalmol
                Acta Ophthalmol
                10.1111/(ISSN)1755-3768
                AOS
                Acta Ophthalmologica
                John Wiley and Sons Inc. (Hoboken )
                1755-375X
                1755-3768
                02 July 2024
                February 2025
                : 103
                : 1 ( doiID: 10.1111/aos.v103.1 )
                : 33-42
                Affiliations
                [ 1 ] Department of Drug Design and Pharmacology University of Copenhagen Copenhagen Denmark
                [ 2 ] School of Computer Science and Mathematics Kingston University Surrey UK
                [ 3 ] Population Health Research Institute St. George's, University of London London UK
                [ 4 ] Department of Ophthalmology, Copenhagen University Hospital Rigshospitalet Glostrup, Copenhagen Denmark
                Author notes
                [*] [* ] Correspondence

                Miriam Kolko, Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.

                Email: miriamk@ 123456sund.ku.dk

                Author information
                https://orcid.org/0000-0003-1520-7226
                https://orcid.org/0000-0002-4114-0267
                https://orcid.org/0000-0001-8697-0734
                Article
                AOS16737 ACTA-24-04-0414.R1
                10.1111/aos.16737
                11704846
                38953839
                3c6e9648-61a7-4e10-b80d-7eb7815403c5
                © 2024 The Author(s). Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 09 April 2024
                : 22 June 2024
                Page count
                Figures: 1, Tables: 7, Pages: 10, Words: 7500
                Categories
                Original Article
                Original Article
                Custom metadata
                2.0
                February 2025
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.5.2 mode:remove_FC converted:07.01.2025

                Ophthalmology & Optometry
                automated retinal image analysis,longitudinal cohort study,retinal vasculometry

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