Retinal vascular signs as predictors of systemic disease outcomes: 10-year evolution in a population-based cohort

美国最近两项基于人群的研究数据强调，视网膜微血管迹象可以预测中老年人的系统性血管和其他重要健康结果，特别是中风、心脏病发作和死亡率，而不受传统血管风险因素的影响。本申请建议在参加蓝山眼科研究(BMES)的人群队列中评估视网膜微血管迹象的10年发展和进展及其与中风和其他重要系统健康结果的发展的关系。将评估两种类型的视网膜体征：第一，特定临床体征的存在，例如视网膜小血管(小动脉)局灶性狭窄，小动脉穿过视网膜静脉时划破视网膜静脉或存在视网膜病变(出血和其他体征)；第二，使用为美国研究开发的计算机辅助方法测量一般视网膜血管口径(狭窄)。我们还将为另外两个标志开发新的分级方法。该中心将对35毫米幻灯片的计算机辅助分级与使用(正在开发的)扫描设备对老年人眼睛进行扫描的血管自动分级进行比较。该项目建立在我们目前为期3年的NHMRC赠款(ID153948；2001-2003)的基础上，将视网膜血管征象作为偶发中风或脑血管死亡的风险标记物：基于人群的评估。在过去的两年中，该机构探索了这些体征的测量和分级的不同方面，记录了它们与血压的关系，并开始评估这些特征是否可以预测澳大利亚老年人的血管事件和其他系统性结果。新项目将使用BMES队列10年检查的数据和视网膜照片来评估视网膜微血管迹象的演变，目前正在收集另一项NHMRC赠款(ID211069；2002-2004)。

Recent U.S. data from two population-based studies have highlighted retinal microvascular signs as being predictive of systemic vascular and other important health outcomes in middle-aged or older individuals, particularly stroke and heart attack and mortality, independent of traditional vascular risk factors. The present application proposes to evaluate the 10-year development and progression of retinal microvascular signs and their relations to the development of stroke and other important systemic health outcomes in the population-based cohort of residents attending the Blue Mountains Eye Study (BMES. Two types of retinal signs will be evaluated: firstly, the presence of specific clinical signs, such as focal narrowing of small retinal vessels (arterioles), nicking of retinal veins as arterioles cross them or presence of retinopathy (haemorrhages and other signs) secondly, measures of generalized retinal vessel calibre (narrowing) using a computer-assisted method developed for the U.S. studies. We will also develop new grading methods for two other signs. Late and will compare computer-assisted grading from 35mm slides to automated grading of vessels using a scanning device (being developed) to screen the eyes of older persons. This project builds upon our current 3-year NHMRC grant (ID153948; 2001-2003) Retinal vascular signs as risk markers for incident stroke or cerebrovascular death: A population-based assessment . In the last 2 years, this has explored different aspects of measurement and grading of these signs, has documented their relation to blood pressure and has begun to assess whether these features predict vascular events and other systemic outcomes in older Australians. The new project will assess the evolution of retinal microvascular signs over a 10-year period, using data and retinal photographs from the 10-year examinations of the BMES cohort, currently being collected, in a further current NHMRC grant (ID211069; 2002-2004).