Retinal Vasculometry Associations With Glaucoma: Findings From the European Prospective Investigation of Cancer-Norfolk Eye Study.
Retinal Vasculometry Associations With Glaucoma: Findings From the European Prospective Investigation of Cancer-Norfolk Eye Study.
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DOI：
10.1016/j.ajo.2020.07.027
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发表时间：
2020-12
影响因子：
4.2
通讯作者：
Foster PJ
中科院分区：
文献类型：
--
作者：
Rudnicka AR;Owen CG;Welikala RA;Barman SA;Whincup PH;Strachan DP;Chan MPY;Khawaja AP;Broadway DC;Luben R;Hayat SA;Khaw KT;Foster PJ
检查英国老年人视网膜血管测量与不同青光眼的关系。横断面研究。共有8623名欧洲前瞻性癌症-诺福克眼研究参与者接受了视网膜成像、眼部生物测量评估和眼高血压或青光眼状态的临床确定（包括青光眼疑似[GS]、高张力开角青光眼[HTG]和正常张力青光眼[NTG]）。自动测量视网膜图像中的小动脉和静脉弯曲度、面积和宽度。主要指标：采用多水平线性回归分析青光眼和视网膜血管测量结果之间的相关性，并对年龄、性别、身高、轴长、眼内和体压以及人内聚类进行校正，以提供宽度和面积的绝对差异，以及血管弯曲的百分比差异。通过诊断检查视网膜血管测量是否存在人眼间差异。共纳入5947名参与者（平均年龄67.6岁，SD 7.6岁，57%为女性）的565,593个血管段；至少1眼HTG、NTG和GS患者分别为87例、82例和439例。细动脉（−3.2 μm， 95%可信区间[CI]−4.4 μm,−1.9 μm）和小静脉（−2.7 μm, 95% CI−4.9 μm,−0.5 μm）与HTG相关。静脉面积减少与HTG （- 0.2 mm2, 95% CI - 0.3 mm2, - 0.1 mm2）和NTG （- 0.2 mm2, 95% CI - 0.3 mm2, - 0.0 mm2）相关。较少弯曲的视网膜小动脉和小静脉与所有青光眼相关，但仅与GS相关（- 3.9%；95% CI分别为- 7.7%,- 0.1%和- 4.8%；95% CI分别为- 7.4%,- 2.1%）。没有证据表明视网膜血管测量与诊断之间存在人与眼之间的差异。视网膜血管宽度与青光眼的相关性以及血管面积和弯曲度的新相关性，以及没有证据表明视网膜血管测量在人与人之间的差异，提示青光眼的血管原因。视网膜血管测量，包括（作为第一份报告）血管弯曲度和面积，与高压性青光眼和其他青光眼相关的结果相关。新的分析表明，人眼间青光眼诊断、眼内压和视网膜血管测量不相关，这进一步证明了全身微血管改变可能导致青光眼。
To examine retinal vasculometry associations with different glaucomas in older British people. Cross-sectional study. A total of 8,623 European Prospective Investigation into Cancer-Norfolk Eye study participants were examined, who underwent retinal imaging, ocular biometry assessment, and clinical ascertainment of ocular hypertensive or glaucoma status (including glaucoma suspect [GS], high-tension open-angle glaucoma [HTG], and normal-tension glaucoma [NTG]). Automated measures of arteriolar and venular tortuosity, area, and width from retinal images were obtained. MainOutcomeMeasures: Associations between glaucoma and retinal vasculometry outcomes were analyzed using multilevel linear regression, adjusted for age, sex, height, axial length, intraocular and systemic blood pressure, and within-person clustering, to provide absolute differences in width and area, and percentage differences in vessel tortuosity. Presence or absence of within-person-between-eye differences in retinal vasculometry by diagnoses were examined. A total of 565,593 vessel segments from 5,947 participants (mean age 67.6 years, SD 7.6 years, 57% women) were included; numbers with HTG, NTG, and GS in at least 1 eye were 87, 82, and 439, respectively. Thinner arterioles (−3.2 μm; 95% confidence interval [CI] −4.4 μm, −1.9 μm) and venules (−2.7 μm; 95% CI −4.9 μm, −0.5 μm) were associated with HTG. Reduced venular area was associated with HTG (−0.2 mm2; 95% CI −0.3 mm2, −0.1 mm2) and NTG (−0.2 mm2; 95% CI −0.3 mm2, −0.0 mm2). Less tortuous retinal arterioles and venules were associated with all glaucomas, but only significantly for GS (−3.9%; 95% CI −7.7%, −0.1% and −4.8%; 95% CI −7.4%, −2.1%, respectively). There was no evidence of within-person-between-eye differences in retinal vasculometry associations by diagnoses. Retinal vessel width associations with glaucoma and novel associations with vessel area and tortuosity, together with no evidence of within-person-between-eye differences in retinal vasculometry, suggest a vascular cause of glaucoma. Retinal vessel measurements, including (as a first report) vessel tortuosity and area, were associated with high-tension glaucoma and other glaucoma-related outcomes. Novel analyses showing that within-person-between-eye glaucoma diagnoses, intraocular pressure, and retinal vasculometry were uncorrelated provides further evidence that systemic microvascular changes may cause glaucoma.
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影响因子：
3.7
作者：
Grieshaber, Matthias C;Flammer, Josef
通讯作者：
Flammer, Josef
影响因子：
3.9
作者：
Cousins, C. C.;Kang, J. H.;Pasquale, L. R.
通讯作者：
Pasquale, L. R.
影响因子：
4.1
作者：
Foster, PJ;Buhrmann, R;Johnson, GJ
通讯作者：
Johnson, GJ
影响因子：
4.2
作者：
Klein, R;Klein, BEK;Wong, TY
通讯作者：
Wong, TY
DOI：
10.1136/bjophthalmol-2018-311846
发表时间：
2019-03
期刊：
The British journal of ophthalmology
影响因子：
--
作者：
Cousins CC;Chou JC;Greenstein SH;Brauner SC;Shen LQ;Turalba AV;Houlihan P;Ritch R;Wiggs JL;Knepper PA;Pasquale LR
通讯作者：
Pasquale LR