The role of retinal vessel geometry as an indicator of systemic arterial stiffness assessed by cardio-ankle vascular index

Dae Joong Ma; Heesun Lee; Ji Min Choi; Hyo Eun Park; Su-Yeon Choi; Hyuk Jin Choi

doi:10.3389/fcvm.2023.1139557

The role of retinal vessel geometry as an indicator of systemic arterial stiffness assessed by cardio-ankle vascular index

Front Cardiovasc Med. 2023 Jun 19:10:1139557. doi: 10.3389/fcvm.2023.1139557. eCollection 2023.

Authors

Dae Joong Ma^#¹, Heesun Lee^#^{2

3}, Ji Min Choi^{2

4}, Hyo Eun Park^{2

3}, Su-Yeon Choi^{2

3}, Hyuk Jin Choi^{5

6}

Affiliations

¹ Department of Ophthalmology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
² Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
³ Division of Cardiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
⁴ Division of Gastroenterology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
⁵ Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
⁶ Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.

^# Contributed equally.

Abstract

Objective: To determine whether retinal vessel geometry is associated with systemic arterial stiffness, as determined by the cardio-ankle vascular index (CAVI).

Methods: This single-center retrospective cross-sectional study included 407 eyes of 407 subjects who underwent routine health exams, including CAVI and fundus photography. Retinal vessel geometry was measured using a computer-assisted program (Singapore "I" Vessel Assessment). Subjects were classified into two groups based on CAVI values: high CAVI (≥9) or low CAVI (<9). The main outcome measures included the association of retinal vessel geometry and CAVI value evaluated using multivariable logistic regression models.

Results: Three hundred forty-three subjects (343, 84.3%) were in the low CAVI group, and 64 (15.7%) subjects were in the high CAVI group. Multivariable logistic linear regression analyses adjusted for age, sex, body mass index, smoking status, mean arterial pressure, and the presence of hypertension, diabetes mellitus, and dyslipidemia showed a significant association between high CAVI values and the following retinal vessel geometry parameters: central retinal arteriolar equivalent caliber (CRAE; adjusted odds ratio [AOR], 0.95; 95% confidence interval [CI], 0.89-1.00; P = 0.043), fractal dimension of arteriolar network (FDa; AOR, 4.21 × 10^-4; 95% CI, 2.32 × 10^-7-0.77; P = 0.042), and arteriolar branching angle (BAa; AOR, 0.96; 95% CI, 0.93-0.99; P = 0.007).

Conclusions: Increased systemic arterial stiffness had a significant association with retinal vessel geometry related to arterial narrowing (CRAE), less branching complexity of the arterial tree (FDa), and acute arteriolar bifurcation (BAa).

Keywords: cardio-ankle vascular index; cardiovascular diseases; retina; vascular stiffness; vessel.

Grants and funding

This research was supported by the SNUH Research Fund (grant no. 0420190710), and the Hallym University Medical Center Research Fund and the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (grant no. 2021R1G1A1093576).