Association of retinal fractal dimension and vessel tortuosity with impaired renal function among healthy Chinese adults

Abstract

PurposeThis study investigated the association of retinal fractal dimension (FD) and blood vessel tortuosity (BVT) with renal function [assessed by estimated glomerular filtrate rate (eGFR)] in healthy Chinese adults using swept-source optical coherence tomographic angiography (SS-OCTA).Materials and methodsThis cross-sectional study was conducted among ocular treatment–naïve healthy participants from Guangzhou, China. FD and BVT in the superficial capillary plexus and deep capillary plexus were measured by SS-OCTA with a 3 × 3 macula model. eGFR was calculated using the Xiangya equation, and impaired renal function (IRF) was defined as eGFR = 90 mL/min/1.73 m2. Linear regression was performed to evaluate the relationships between SS-OCTA metrics and renal function.ResultsA total of 729 participants with a mean age of 57.6 ± 9.1 years were included in the final analysis. Compared to participants with normal renal function, those with IRF had lower FD both in the superficial capillary plexus (1.658 ± 0.029 vs. 1.666 ± 0.024, p = 0.001) and deep capillary plexus (1.741 ± 0.016 vs. 1.746 ± 0.016, p = 0.0003), while the deep BVT was larger in participants with IRF than those with normal renal function (1.007 ± 0.002 vs. 1.006 ± 0.002, p = 0.028). The superficial FD was linearly and positively associated with eGFR after adjusting for confounders (β = 0.2257; 95% CI 0.0829–0.3685; p = 0.002), while BVT was not associated with eGFR (all p ≥ 0.05).ConclusionThe patients with IRF had lower FD and larger BVT than those with normal renal function. The superficial FD decreased linearly with renal function deterioration. Our study suggests that the retinal microvasculature can represent a useful indicator of subclinical renal microvascular abnormalities and serve as a useful non-invasive assessment to predict and monitor the progression of renal function.

Retinal Vascular Imaging Application in Women’s Reproductive Health: Clinical Implications and Future Directions

“…25 In ensuing pregnancies, individuals with higher preconception and greater arteriolar and venular curvature tortuosity encountered a 25-34% increased risk of spontaneous abortion before 20 weeks' gestation. 26 The underlying pathophysiology, characterized by vascular inflammation, 27,28 hypoxia, 15,16 oxidative stress, 29 endothelial dysfunction, [30][31][32] and impaired uterine perfusion, 33,34 contributes to both reduced fecundability and spontaneous abortion, in addition to common risk factors like advanced maternal age, 35,36 stress, 37 cigarette smoking, 38 medication or substance use, 39,40 medical conditions, [41][42][43] and environmental pollution. 44 Women's antenatal health…”