A new tool to assess retinal vessel caliber. Reliability and validity of measures and their relationship with cardiovascular risk

García‐Ortiz, Luis; Recio-Rodríguez, José I.; Parra-Sanchez, J.; Elena, L.J. González; Patino-Alonso, María C.; Agudo‐Conde, Cristina; Rodríguez‐Sánchez, Emiliano; Gómez‐Marcos, Manuel A.

doi:10.1097/hjh.0b013e3283506628

Cited by 31 publications

(28 citation statements)

References 37 publications

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“…As early as 1974, Parr and Spear proposed the central retinal equivalent for arteries (Parr & Spears 1974a,b) that was extended to retinal veins by Hubbard et al in 1999(Hubbard et al 1999. Later on, several computer-based measurements were programmed and evaluated in epidemiological as well as in clinical and experimental studies (Wong et al 2004;Benavent et al 2009;Cheung et al 2010;Garcia-Ortiz et al 2012;Papadopoulou et al 2012;Pemp et al 2013;Schuster et al 2013).…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography‐based retinal vessel analysis for the evaluation of hypertensive vasculopathy

Schuster

Fischer

Vossmerbaeumer³

et al. 2014

Acta Ophthalmologica

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Section: Discussionmentioning

confidence: 99%

Optical coherence tomography‐based retinal vessel analysis for the evaluation of hypertensive vasculopathy

Schuster

Fischer

Vossmerbaeumer³

et al. 2014

Acta Ophthalmologica

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“…In their investigation, Garcia-Ortiz et al [20] were able to demonstrate an independent association between arteriovenular ratio (AVR), venular caliber, but not the arteriolar one, with Framingham score and microalbuminuria. According to multivariate analyses, the strength of association of venular caliber with Framingham score and microalbuminuria was stronger than that found for AVR; the association with this last parameter, indeed, lost the statistical significance after adjustment for sex.…”

Section: New Insights and Perspectives From The Study By Garcia-ortizmentioning

confidence: 95%

“…Some further aspects of the study by Garcia-Ortiz et al [20] deserve a mention. At difference from some previous reports but in accordance with others, their study showed no significant relationship between retinal arteriolar diameter and carotid atherosclerosis, pulse wave velocity and left ventricular hypertrophy as assessed by electrocardiographic criteria.…”

Section: New Insights and Perspectives From The Study By Garcia-ortizmentioning

confidence: 96%

“…In the current issue of the Journal of Hypertension, GarciaOrtiz et al [20] report the findings of a cross-sectional study aimed at evaluating the reliability of semi-automated measurements of retinal vessel caliber as well as the relationship of these measurements with validated markers of organ damage such as left ventricular hypertrophy, carotid intima-thickness, pulse wave velocity, microalbuminuria, glomerular filtration rate and estimates of cardiovascular risk based on the Framingham score. For this purpose, the authors investigated 110 untreated and treated hypertensive patients, 55 diabetic patients and 45 healthy individuals, aged 34-75 years, free of overt cardiovascular disease, referred to a primary care clinics.…”

Section: New Insights and Perspectives From The Study By Garcia-ortizmentioning

confidence: 99%

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Do microvascular retinal changes improve cardiovascular risk estimation?

Cuspidi

Sala

2012

Journal of Hypertension

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F undoscopic examination is a unique, noninvasive tool allowing the assessment of retinal vessel changes induced by high blood pressure (BP), which, in turn, may reflect cerebral microangiopathic alterations. Mechanical stretch and increased arteriolar transmural pressure combined with metabolic disorders associated with hypertension cause the release from endothelial cells of neurohormonal factors influencing arteriolar smooth muscle and pericyte tone [1]. Locally activated humoral factors, including angiotensin II, endothelin and insulin, induce arteriolar lumen narrowing, apoptosis of vascular smooth muscle cells and vascular fibrosis. Subtle changes in retinal microcirculation, characterized by increased arteriolar wall-to-lumen ratio and venular dilatation, represent an early stage frequently observed in hypertensive retinopathy. More advanced stages of retinopathy, including the 'exudative stage' (i.e. disruption of the blood-retina barrier, exudation of blood and lipids, retinal ischemia) characterized by microaneurysms, hemorrhages, hard exudates, cotton-wool spots and papilloedema, are fortunately rarely found in current hypertension to day [2].Since the pioneering study by Keith et al. [3], showing a strong association between hypertensive retinopathy and incident mortality, a vast amount of data has been accumulated about the clinical and prognostic value of this condition across different clinical settings and ethnicities. In the observational survey by Keith et al.[3], including 219 hypertensive patients, the authors reported a dramatic decline in survival during a 5-year follow-up period from grade 1 to 4 retinopathy. All-cause mortality rate was strongly related to retinopathy, increasing from 30% in grade 1, to 46% in grade 2, 80% in grade 3, up to 99% in grade 4. In the decades from 1950 through 1980, several reports confirmed the association of hypertensive retinal vascular damage with excess cardiovascular morbidity, in particular with stroke [4,5]. These findings, however, have a limited application to contemporary clinical practice, due to a number of limitations. First, retinal alterations were simply defined by fundoscopic examination, a method affected by poor intraobserver and interobserver reproducibility. Second, in older studies, more advanced degrees of retinopathy, including hemorrhages and exudates, were observed in the majority of patients. However, focal or generalized arteriolar narrowing and arteriovenous crossing are the most prevalent retinal alterations observed in contemporary hypertension, more frequently detected than other markers of organ damage with proven prognostic value (i.e. left ventricular hypertrophy, carotid intimamedia thickening or plaques and microalbuminuria). Moreover, the prognostic value of these retinal alterations has been questioned by several cross-sectional studies [6,7]. Thus, the 2007 European Society of Hypertension-European Society of Cardiology guidelines stated that examination of eye grounds is only recommended in patients with severe hyperten...

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“…Studies based on a software called 'AVIndex' and their results has been published in (García-Ortiz et al, 2012). They have requested the extension of such software in order to complete their studies, since the extracted information is now scarce.…”

Section: 1!tools and Techniquesmentioning

confidence: 99%

ALTAIR: Supervised Methodology to Obtain Retinal Vessels Caliber

Chamoso

Pérez-Ramos

García-García

2014

ADCAIJ

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A new tool to assess retinal vessel caliber. Reliability and validity of measures and their relationship with cardiovascular risk

Abstract: This tool showed a high intraobserver and interobserver reliability, and results of the validity analysis agree with those from large studies in estimation of cardiovascular risk and evaluation of target organ damage.

Cited by 31 publications

References 37 publications

Optical coherence tomography‐based retinal vessel analysis for the evaluation of hypertensive vasculopathy

Optical coherence tomography‐based retinal vessel analysis for the evaluation of hypertensive vasculopathy

Do microvascular retinal changes improve cardiovascular risk estimation?

ALTAIR: Supervised Methodology to Obtain Retinal Vessels Caliber

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