Age-Related Decrease of the Retinal Vasculature Area Identified with a Novel Computer-Aided Analysis System

Abstract

Fundus photographs enable non-invasive analysis of the status of the microcirculation by directly observing the retinal vasculature. Retinal microvascular abnormalities are important clinical markers of hypertension and arteriosclerosis, but retinal microvascular changes can be observed in older individuals without hypertension. In this study, our goal is to elucidate the effects of aging on fundus vessels in the retinal photograph. We analyzed retinal vessels of 161 healthy volunteers (49.5 ± 18.7 years, range 18-87) using in-house computer-aided measurement system to measure areas and diameters of all retinal vessels across the entire area of a retinal photograph. The vessels were segmented according to color, and then their area, size, length and thickness were measured by image processing. We also analyzed the correlation between total blood vessel area, age and mean arterial blood pressure (MABP). The decrease in total blood vessel area was dependent on both age and MABP. Moreover, decrease in blood vessel area was also correlated with age for the normotensive group. Furthermore, the slope of the regression line for retinal vessel area with MABP was significantly higher in participants aged ≤ 60 years than in those aged over 60 years. Changes in retinal vessel area with aging were observed in both arterioles and venules. In conclusion, we found the significant decrease in retinal vessel area that is correlated well with calendar age. Therefore, we need to carefully apply traditional classifications of fundus examination for hypertensive retinopathy in older individuals.

Quantitative Study of the Macular Microvasculature in Human Donor Eyes

“…SL density was found to be significantly higher in the older donor eyes, independent of the DL vascular density. This was an unexpected finding, as quite a few studies have identified an age-related decrease in retinal vasculature area, 40 ganglion cell layer Vessel density is expressed as percentage 6 SD; n value in parentheses indicates the number of measurements included in the calculation of mean value. thickness, 38 reduction in ganglion cell density, and rod photoreceptor cell 37 and rod bipolar cell density 41 with aging.…”

The Effects of Arterial Hypertension and Age on the Sublingual Microcirculation of Healthy Volunteers and Outpatients with Cardiovascular Risk Factors

“…Although older patients have higher blood pressure and arterial hypertension is more frequent in the elderly, the multiple linear regression analysis only identified the preexistent arterial hypertension as an independent determinant of PVD small vessels . Several experimental and clinical studies showed an agerelated worsening in microvascular flow in liver [25], cerebral cortex [25], retina [45], and cochlea [40]. Conflicting findings, however, have been described in other territories.…”

“…The alterations include reductions in luminal diameter [32], vascular density [4], and RBCV small vessels [30]. In hypertensive patients, several studies showed decreased capillary density in dermis [2][3][4] muscle [28], conjunctiva [41], and retina [45]. This is the first study that assessed the effects of chronic arterial hypertension on sublingual microcirculation.…”

“…Many experimental studies have reported microvascular structural rarefaction in hypertensive models. The compromised tissues include skeletal muscle , intestine , skin , and retina . These microcirculatory disorders are ubiquitous hallmarks of the long‐term complications of hypertension .…”

“…The alterations include reductions in luminal diameter , vascular density , and RBCV small vessels . In hypertensive patients, several studies showed decreased capillary density in dermis muscle , conjunctiva , and retina .…”