The Relationship of Retinal Vessel Diameters and Fractal Dimensions with Blood Pressure and Cardiovascular Risk Factors

Abstract

BackgroundThis study aimed to investigate the correlation between quantitative retinal vascular parameters such as central retinal arteriolar equivalent (CRAE) and retinal vascular fractal dimension (D(f)), and cardiovascular risk factors in the Chinese Han population residing in the in islands of southeast China.Methodology/Principle FindingsIn this cross-sectional study, fundus photographs were collected and semi-automated analysis software was used to analyze retinal vessel diameters and fractal dimensions. Cardiovascular risk factors such as relevant medical history, blood pressure (BP), lipids, and blood glucose data were collected. Subjects had a mean age of 51.9±12.0 years and included 812 (37.4%) males and 1,357 (62.6%) females. Of the subjects, 726 (33.5%) were overweight, 226 (10.4%) were obese, 272 (12.5%) had diabetes, 738 (34.0%) had hypertension, and 1,156 (53.3%) had metabolic syndrome. After controlling for the effects of potential confounders, multivariate analyses found that age (β = 0.06, P = 0.008), sex (β = 1.33, P = 0.015), mean arterial blood pressure (β = −0.12, P<0.001), high-sensitivity C-reactive protein (β = −0.22, P = 0.008), and CRVE (β = 0.23, P<0.001) were significantly associated with CRAE. Age (β = −0.0012, P<0.001), BP classification (prehypertension: β = −0.0075, P = 0.014; hypertension: β = −0.0131, P = 0.002), and hypertension history (β = −0.0007, P = 0.009) were significantly associated with D(f).Conclusions/SignificanceD(f) exhibits a stronger association with BP than CRAE. Thus, D(f) may become a useful indicator of cardiovascular risk.

Retinal Vascular Fractals Correlate With Early Neurodegeneration in Patients With Type 2 Diabetes Mellitus

“…21 Most clinical studies measuring Fd have included patients with type 1 diabetes mellitus, 12,13,22À24 patients with increased levels of HbA1c, 25,26 or examined data from patients with diabetes who developed DR over time. 27À29 In a cross-sectional study, Grauslund et al 12 found an independent correlation between lower Fd and the presence of inactive PDR as well as neuropathy.…”

Effect of Axial Eye Length on Retinal Vessel Parameters in 6 to 12-Year-Old Malay Girls

“…The fractal dimension was the gradient of the logarithm of the number of squares through which the vessel outline passes against the logarithm of the size of the square [7]. Larger values indicated a more complex branching pattern [26]. …”

Assessment of Early Hypertensive Retinopathy using Fractal Analysis of Retinal Fundus Image

“…It was confirmed that changes sharply in the arch that affect the retinal blood vessels fractal dimensional changes. This is reinforced in research Zhu et al [13], which explains that the fractal dimension associated with blood pressure and cardiovascular risk factors. Blood pressure (hypertension) acute is the major cause hypertensive retinopathy.…”

“…The study was supported by research conducted Zhu et.al [13]. The study explains that the fractal dimension retinal images have a relationship with blood pressure and central retinal arteriolar equivalent (CRAE) so that the fractal dimension can also be used as an indicator of cardiovascular risk [13].…”

“…The fractal dimension can be used to determine the relationship of changes in retinal blood vessels of mortality caused by coronary heart disease [12]. The study was supported by research conducted Zhu et.al [13]. The study explains that the fractal dimension retinal images have a relationship with blood pressure and central retinal arteriolar equivalent (CRAE) so that the fractal dimension can also be used as an indicator of cardiovascular risk [13].…”