Large artery stiffness, which occurs with aging and various pathologic states, delivers excessive pulsatile energy into the microvasculature of target organs that then undergo corresponding damage ( 4). In addition, retinal vessel geometry parameters such as caliber, fractal dimension, tortuosity, and bifurcation angle were quantified using computer-assisted programs and showed associations with cardiovascular or cerebrovascular diseases ( 2, 3). Several studies have shown that classic retinal microvascular signs such as microaneurysms, retinal hemorrhages, generalized or focal arteriolar narrowing, and arteriovenous nicking could provide information with respect to the risk of cardiovascular or cerebrovascular events ( 1). The retinal vessels are the only part of human circulation that can be directly and noninvasively visualized in vivo. 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, 0.95 95% confidence interval, 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).Ĭonclusions: 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). 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. The main outcome measures included the association of retinal vessel geometry and CAVI value evaluated using multivariable logistic regression models. Subjects were classified into two groups based on CAVI values: high CAVI (≥9) or low CAVI (<9). Retinal vessel geometry was measured using a computer-assisted program (Singapore “I” Vessel Assessment). Methods: This single-center retrospective cross-sectional study included 407 eyes of 407 subjects who underwent routine health exams, including CAVI and fundus photography. Objective: To determine whether retinal vessel geometry is associated with systemic arterial stiffness, as determined by the cardio-ankle vascular index (CAVI). 6Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.5Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea. 4Division of Gastroenterology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.3Division of Cardiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.1Department of Ophthalmology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.Dae Joong Ma 1,†, Heesun Lee 2,3,†, Ji Min Choi 2,4, Hyo Eun Park 2,3, Su-Yeon Choi 2,3 and Hyuk Jin Choi 5,6*
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