Comparisons between retinal vessel calibers and various optic disc morphologic parameters with different optic disc appearances: The Glaucoma Stereo Analysis Study

Abstract

The Glaucoma Stereo Analysis Study (GSAS) is a multicenter collaborative study of the characteristics of glaucomatous optic disc morphology using a stereo fundus camera. This study evaluated the retinal vessel calibers and correlations using GSAS fundus photographs between retinal vessels and 38 optic nerve head (ONH) morphologic parameters comprehensively. In all 240 eyes, the mean central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were 138.4 and 216.5 μm, respectively; the CRAE correlated with age, visual field scores and 19 ONH parameters and CRVE correlated with age, intraocular pressure, visual field scores and 11 ONH parameters. Among the different optic disc appearances including focal ischemia (FI) (n = 53, 22%), generalized enlargement (GE) (n = 53, 22%), myopic glaucoma (MY) (n = 112, 47%), and senile sclerosis (SS) (n = 22, 9%), the CRAE did not differ significantly; CRVE was significantly narrower in SS than in FI and MY. In FI, GE, MY, and SS disc types, CRAE correlated with 3, 14, 9, and 2 ONH parameters, respectively, and CRVE corelated with 9, 0, 12, and 6 ONH parameters, respectively. We confirmed previous observations on the effect of retinal vessel narrowing on glaucomatous changes in the ONH and visual field. The associations between retinal vessel caliber and ONH morphologic parameters vary among different optic disc appearances, suggesting different effects of vascular changes in each disc type.

Computerized analysis of the eye vasculature in a mass dataset of digital fundus images: the example of age, sex and primary open-angle glaucoma

“…In 2021, retinal multifractal dimensions (n= 2,333) were associated with blood pressure and cardiovascular disease 20 . In POAG patients, a lower arteriolar and venular fractal dimension was observed compared to healthy controls, however, these studies are small (n = 87 and n = 61 POAG cases) 4,21 . In 2022, a study of 1,770 patients suggested that a set of vascular biomarkers could undergo changes in response to hypertension.…”

“…In 2009, Sabanayagam et al reported that individuals with reduced CRAE were more likely to have chronic kidney disease than those with increased CRAE (n=2581) 3 . Regarding primary open-angle glaucoma (POAG), several studies found lower CRAE in POAG patients compared to healthy controls; however, none of these studies included more than several hundred glaucoma cases [4][5][6][7][8][9][10][11][12][13] . Similar to CRAE but to a lesser extent, lower CRVE is commonly found in this population 4,[6][7][8][9][10][11][12][13] .…”

“…Regarding primary open-angle glaucoma (POAG), several studies found lower CRAE in POAG patients compared to healthy controls; however, none of these studies included more than several hundred glaucoma cases [4][5][6][7][8][9][10][11][12][13] . Similar to CRAE but to a lesser extent, lower CRVE is commonly found in this population 4,[6][7][8][9][10][11][12][13] . In the subsequent decade, fractal dimension of the retinal vascular tree emerged as a risk predictor of cardiovascular disease.…”

Plxnd1-mediated mechanosensing of blood flow controls the caliber of the Dorsal Aorta via the transcription factor Klf2

“…The novel role of PLXND1 and KLF2 as vascular caliber regulators suggests that variants in these genes could contribute to diseases involving reduced vascular calibers, myocardial ischemia [173,174], peripheral artery disease [175], atherosclerosis [29], hypertension [176], diabetes [177], and glaucoma [178]. Thus, increasing the expression or activity of Plexin D1 and KLF2 might therapeutically enhance the blood flow in individuals afflicted by these conditions and in patients with congenital heart defects suffering from impaired cardiac blood flow.…”

Value of Combining Optical Coherence Tomography with Fundus Photography in Screening Retinopathy in Patients with High Myopia

“…Fundus fluorescence imaging can present retinal and choroidal blood circulation, and dynamically and objectively record small changes in the center and periphery of the macula in affected eyes of patients with high myopia, which is beneficial for providing an objective basis for clinical treatment. However, fundus fluorescence imaging is an invasive examination with complicated operation steps and high risk coefficient, and the research by Sugihara Kazunobu found that such examination had low acceptance [ 19 ], which cannot meet the potential screening needs in China with a large population base and high incidence of myopia. Compared with fundus fluorescence imaging, the novel OCT technique has the advantages such as noninvasion and easy operation, which can quantitatively analyze the retinal structure through noncontact ways, so that physicians can observe the retinal tomographic imaging horizontally, vertically, and via radiation, and obtain more precise retinal information, thereby providing more basis for evaluating retinopathy [ 20 – 22 ].…”