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Retinal vascular geometry and glaucoma: the Singapore Malay Eye Study.
Ophthalmology 2013; 120(1):77-83O

Abstract

PURPOSE

To determine the associations of geometric measurements (tortuosity, branching angle, and fractal dimension) of retinal vessels with glaucoma.

DESIGN

Population-based, cross-sectional study.

PARTICIPANTS

Persons aged 40 to 80 years who participated in the Singapore Malay Eye Study (n=3280; 78.7% response rate).

METHODS

Quantitative retinal vascular parameters (tortuosity, branching angle, and fractal dimension) were measured from digital retinal fundus photographs using a computer-assisted program following a standardized grading protocol. Glaucoma was diagnosed according to the International Society of Geographic and Epidemiological Ophthalmology classification system.

MAIN OUTCOME MEASURES

The associations among retinal vascular parameters with glaucoma, the main glaucoma subtype primary open-angle glaucoma (POAG), and ocular hypertension (OHT).

RESULTS

A total of 123 persons (4.4% of the 2789 participants) had glaucoma in the final analysis, 87 (70.7%) of whom were diagnosed with POAG. After adjusting for age, sex, body mass index, diabetes, hypertension, smoking, axial length, and intraocular pressure (IOP), decreased retinal arteriolar tortuosity (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.38-2.18, comparing lowest vs. highest quartiles), decreased retinal venular tortuosity (OR, 1.59; 95% CI, 1.29-1.97), and narrower retinal venular branching angle (OR, 1.22; 95% CI, 1.00-1.48) were associated with glaucoma. Similar associations were found between these retinal vascular parameters and POAG. Decreased retinal vascular fractal dimension was associated with OHT (OR 1.37; 95% CI, 1.04-1.82).

CONCLUSIONS

Certain features of retinal vascular geometry are associated with glaucomatous optic neuropathy independently of vascular risk factors and IOP.

FINANCIAL DISCLOSURE(S)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Authors+Show Affiliations

Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23009894

Citation

Wu, Renyi, et al. "Retinal Vascular Geometry and Glaucoma: the Singapore Malay Eye Study." Ophthalmology, vol. 120, no. 1, 2013, pp. 77-83.
Wu R, Cheung CY, Saw SM, et al. Retinal vascular geometry and glaucoma: the Singapore Malay Eye Study. Ophthalmology. 2013;120(1):77-83.
Wu, R., Cheung, C. Y., Saw, S. M., Mitchell, P., Aung, T., & Wong, T. Y. (2013). Retinal vascular geometry and glaucoma: the Singapore Malay Eye Study. Ophthalmology, 120(1), pp. 77-83. doi:10.1016/j.ophtha.2012.07.063.
Wu R, et al. Retinal Vascular Geometry and Glaucoma: the Singapore Malay Eye Study. Ophthalmology. 2013;120(1):77-83. PubMed PMID: 23009894.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retinal vascular geometry and glaucoma: the Singapore Malay Eye Study. AU - Wu,Renyi, AU - Cheung,Carol Yim-Lui, AU - Saw,Seang Mei, AU - Mitchell,Paul, AU - Aung,Tin, AU - Wong,Tien Yin, Y1 - 2012/09/23/ PY - 2011/10/26/received PY - 2012/07/11/revised PY - 2012/07/11/accepted PY - 2012/9/27/entrez PY - 2012/9/27/pubmed PY - 2013/3/8/medline SP - 77 EP - 83 JF - Ophthalmology JO - Ophthalmology VL - 120 IS - 1 N2 - PURPOSE: To determine the associations of geometric measurements (tortuosity, branching angle, and fractal dimension) of retinal vessels with glaucoma. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Persons aged 40 to 80 years who participated in the Singapore Malay Eye Study (n=3280; 78.7% response rate). METHODS: Quantitative retinal vascular parameters (tortuosity, branching angle, and fractal dimension) were measured from digital retinal fundus photographs using a computer-assisted program following a standardized grading protocol. Glaucoma was diagnosed according to the International Society of Geographic and Epidemiological Ophthalmology classification system. MAIN OUTCOME MEASURES: The associations among retinal vascular parameters with glaucoma, the main glaucoma subtype primary open-angle glaucoma (POAG), and ocular hypertension (OHT). RESULTS: A total of 123 persons (4.4% of the 2789 participants) had glaucoma in the final analysis, 87 (70.7%) of whom were diagnosed with POAG. After adjusting for age, sex, body mass index, diabetes, hypertension, smoking, axial length, and intraocular pressure (IOP), decreased retinal arteriolar tortuosity (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.38-2.18, comparing lowest vs. highest quartiles), decreased retinal venular tortuosity (OR, 1.59; 95% CI, 1.29-1.97), and narrower retinal venular branching angle (OR, 1.22; 95% CI, 1.00-1.48) were associated with glaucoma. Similar associations were found between these retinal vascular parameters and POAG. Decreased retinal vascular fractal dimension was associated with OHT (OR 1.37; 95% CI, 1.04-1.82). CONCLUSIONS: Certain features of retinal vascular geometry are associated with glaucomatous optic neuropathy independently of vascular risk factors and IOP. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/23009894/Retinal_vascular_geometry_and_glaucoma:_the_Singapore_Malay_Eye_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(12)00700-2 DB - PRIME DP - Unbound Medicine ER -