CO-01: Retinal arterioles remodeling evaluated by adaptive optics camera in humans and its relationships with age, blood pressure and cardio-vascular risk factors

Abstract

Background Microvascular vessels and microvascular remodeling play a major role in blood pressure (BP) regulation and peripheral tissue oxygen delivery. The adaptive optics camera (AOC), a novel technique of fundus image analysis enables the noninvasive characterization of microvascular remodeling in the retina on a large scale. Our objective was to assess the role of Blood Pressure (BP), ageing, diabetes and other risk factors on retinal arteriolar remodeling using AOC. Methods In 1.000 consecutive subjects in primary prevention with risk factors, we used the new RTX1 ® AOC (Imagine-Eyes, Orsay, France) and a semi-automated segmentation software to measure Wall Thickness (WT), Internal Diameter (ID) and to calculate Wall-to-Lumen Ratio (WLR) and Wall Cross Sectional Area (WCSA) on retinal arteriolar microvasculature. BP was assessed on standard conditions using oscillometric device during the AOC assessment. Hypertension was defined as the presence of Systolic BP>140mmHg and/or Diastolic BP>90mmHg. Standardized clinical and biological examinations were performed to assess for the presence of diabetes, dyslipidemia, obesity and current smoking which were defined according to guidelines. Results Overall, ageing was associated with an increase in WLR due to sole WT increase. Subjects with office hypertension (n = 313) had inward eutrophic remodeling with increased WLR (0.325±0.049 vs 0.292±0.056) due to higher WT, lower ID and overall stable WCSA. Diabetics (n = 180) presented with hypertrophic remodeling indicated by higher WLR due to a significant increase in WT and WCSA concomitant to a normal BP. There was no significant remodeling associated with other cardiovascular risk factors. In multivariate analysis, BP and age remained independent positive correlates of WLR and WT whereas age had no influence on ID and only BP negatively correlated to ID Abstract CO-01 – Table N Retinal Arteriolar Microvasculature Blood Pressure WLR ID.-μm WT.-μm WCSA.-μm 2 Systolic BP.-MmHg Diastolic BP.-MmHg Gender Female 489 0.301 ± .0.50 79.0 ± 10.9 23.5 ± 3.6 3386 ± 817 * 129.5 ± 21.2 72.2 ± 13.7 Male 511 0.300 ± .0.57 77.3 ± 11.1 22.89 ± 4.2 3234 ± 886 132.2 ± 19.4 71.5 ± 13.8 Hypertension Yes 313 0.325 ± .0.49 ‡ 75.6 ± 10.9 † 24.2 ± 4.0 ‡ 3392 ± 832 153.1 ± 16.1 ‡ 82.1 ± 14.8 ‡ No 687 0.292 ± .0.56 78.6 ± 10.8 22.7 ± 3.6 3249 ± 873 120.8 ± 12.4 67.1 ± 10.3 Diabetes Yes 180 0.308 ± .0.52 79.5 ± 11.2 24.2 ± 3.8 ‡ 3523 ± 861 † 134.4 ± 19.6 70.8 ± 13.6 No 820 0.299 ± .0.55 77.8 ± 11.2 23.0 ± 3.9 3256 ± 844 130.2 ± 20.5 72.1 ± 13.9 Dyslipidemia Yes 436 0.301 ± .0.57 77.6 ± 11.1 23.3 ± 4.1 3333 ± 828 130.4 ± 20.0 69.4 ± 12.2 ‡ No 564 0.301 ± .0.53 78.6 ± 11.1 23.2 ± 3.7 3281 ± 886 131.3 ± 20.6 73.7 ± 14.6 Obesity Yes 164 0.303 ± .0.55 77.0 ± 11.4 23.2 ± 3.9 3255 ± 838 136.1 ± 20.3 ‡ 76.3 ± 13.2 ‡ No 836 0.300 ± .0.55 78.2 ± 10.8 23.1 ± 3.9 3307 ± 838 129.3 ± 20.3 70.5 ± 13.7 WLR is Wall-to-Lumen Ratio, ID is internal Diameter, WT is Wall Thickness, WCSA is Wall Cross Sectionnal Area, BP is blood pressure * p † p ‡ p Conclusions Hypertension, age and diabetes are associated with increase in WLR and WT. Assessment OF WT and ID are mandatory to perform a correct interpretation of WLR increase. OAC could represent a promising tool for interventional studies on treatment-induced remodeling regression.