Emphasis on the study of correlation between retinal vascular abnormalities and systemic vascular diseases_Chinese Journal of Ocular Fundus Diseases

Authors：

DuJiantong ,  YangLiu

Department of Ophthalmology, Peking University First Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100034, China;

Corresponding author：

YangLiu, Email: lucy02114@163.com

Keywords：

Retinal vessels/injuries; Vascular diseases/prevention & control; Tomography,optical coherence; Editorial

DOI：

10.3760/cma.j.issn.1005-1015.2016.04.002

Video：

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The abnormalities of retinal vessels such as retinal arteriolar narrowing, arteriovenous nicking, micro-aneurysms, retinal hemorrhages, and cotton wool spot are closely related to systemic diseases including hypertension, diabetes mellitus, cardiovascular disorders, stroke and renal diseases. The modern retinal vessels examination technology has features of quick noninvasive, quantitative standardized and intelligent analysis. Taking advantage of these to fully discover the retinal vascular abnormalities and get deeper understanding of the relationship between its' mechanism and systemic vascular diseases is not only helpful to better diagnose and treat retinal vascular diseases, but also contributes to predicting the risk and prognosis of systemic diseases. We suggest emphasizing on the study of correlation between retinal vascular abnormalities and systemic vascular diseases using modern retinal vessels examination technology. It will provide the preventive clue of diseases of circulatory system by finding out the retinopathy. Meanwhile, correctly treating systemic diseases would get a better prognosis of the retinopathy. They exist side by side and play a part together for providing a better prognosis, which would be a new direction for the doctors and scientists in the new era.

Citation： DuJiantong, YangLiu. Emphasis on the study of correlation between retinal vascular abnormalities and systemic vascular diseases. Chinese Journal of Ocular Fundus Diseases, 2016, 32(4): 349-352. doi: 10.3760/cma.j.issn.1005-1015.2016.04.002 Copy

1.	Wong TY, Mcintosh R. Systemic associations of retinal microvascular signs:a review of recent population-based studies[J]. Ophthalmic Physiol Opt, 2005,25(3):195-204.
2.	Hubbard LD, Brothers RJ, King WN, et al. Methods for evaluation of retinal microvascular abnormalities associated with hypertension/sclerosis in the atherosclerosis risk in communities study[J]. Ophthalmology, 1999, 106(12):2269-2280.
3.	Liew G,Wang JJ,Cheung N,etal The retinal vasculature as a fractal:methodology,reliability,and relationship to blood pressure[J]. Ophthalmology,2008, 115(11):1951-1956. DOI:10.1016/j.ophtha.2008.05.029.
4.	Cheung CY,Tay WT,Mitchell P,et al Quantitative and qualitative retinal microvascular characteristics and blood pressure[J].J Hypertens,2011,29(7):1380-1391.DOI:10.1097/HJH.0b013e328347266c.
5.	Cheung CY,Thomas GN,Tay W,et al.Retinal vascular fractal dimension and its relationship with cardiovascular and ocular risk factors[J].Am J Ophthalmol,2012, 154(4):663-674.DOI:10.1016/j.ajo.2012.04.016.
6.	Sng CC, Wong WL, Cheung CY, et al. Retinal vascular fractal and blood pressure in a multiethnic population[J].J Hypertens,2013,31(10):2036-2042. DOI:10.1097/HJH.0b013e328362c201.
7.	Wong TY, Klein R, Sharrett AR, et al. The prevalence and risk factors of retinal microvascular abnormalities in older people:the Cardiovascular Health Study[J]. Ophthalmology, 2003, 110(4):658-666.
8.	Wong TY, Klein R, Klein BEK, et al. Retinal vessel diameters and their associations with age and blood pressure[J].Invest Ophthalmol Vis Sci,2003, 44(11):4644-4650.
9.	Hughes AD, Stanton AV, Jabbar AS, et al. Effect of antihypertensive treatment on retinal microvascular changes in hypertension[J].J Hypertens,2008,26(8):1703-1707. DOI:10.1097/HJH.0b013e328304b072.
10.	Antonio PR, Marta PS, Luís DD, et al. Factors associated with changes in retinal microcirculation after antihypertensive treatment[J].J Hum Hypertens,2014, 28(5):310-315. DOI:10.1038/jhh.2013.108.
11.	Libondi T, Jonas JB, Wang S, et al. Major eye diseases and risk factors associated with systemic hypertension in an adult chinese population:The Beijing Eye Study[J]. Ophthalmology,2009,116(12):2373-2380. DOI:10.1016/j.ophtha.2009.05.041.
12.	Wong TY, Shankar A, Klein R,et al.Prospective cohort study of retinal vessel diameters and risk of hypertension[J].BMJ,2004,329(7457):79.
13.	Wong TY, Klein R, Sharrett R, et al. Retinal arteriolar diameter and risk for hypertension[J].Ann Intern Med, 2004, 140(4):248-255.
14.	Ikram MK, Witteman JCM, Vingerling JR, et al.Retinal vessel diameters and risk of hypertension:the Rotterdam Study[J]. Hypertension, 2006, 47(2):189-194.
15.	Ding J, Wai KL, McGeechan K,et al.Retinal vascular caliber and the development of hypertension:a meta-analysis of individual participant data[J].J Hypertens, 2014,32(2):207-215. DOI:10.1097/HJH.0b013e32836586f4.
16.	Wong TY, Coresh J, Klein R, et al. Retinal microvascular abnormalities and renal dysfunction:the atherosclerosis risk in communities study[J].J Am Soc Nephrol, 2004,15(9):2469-2476.
17.	Amemiya T, Bhutto IA. Retinal vascular changes and systemic diseases:corrosion cast demonstration[J].Ital J Anat Embryol,2001,106(2 Suppl 1):S237-244.
18.	Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality:a meta-analysis of individual data for one million adults in 61 prospective studies[J]. Lancet,2002,360(9349):1903-1913.
19.	Wong TY, Klein R, Nieto FJ,et al.Retinal microvascular abnormalities and 10-year cardiovascular mortality:a population-based case-control study[J]. Ophthalmology,2003,110(5):933-940.
20.	Wong TY, Klein R, Couper DJ, et al. Retinal microvascular abnormalities and incident stroke:the atherosclerosis risk in communities study[J]. Lancet, 2001, 358(9288):1134-1140.
21.	Mitchell P, Wang JJ, Wong TY, et al. Retinal microvascular signs and risk of stroke and stroke mortality\|NOVA. The University of Newcastle's Digital Repository[J]. University of Newcastle, 2005.
22.	Ikram MK, de Jong FJ, Bos MJ,et al.Retinal vessel diameters and risk of stroke:the Rotterdam Study[J].Neurology,2006,66(9):1339-1343.
23.	Wong TY, McIntosh R.Hypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality[J].Br Med Bull,2005,73-74:57-70.
24.	Mcgeechan K, Liew G, Macaskill P, et al. Risk prediction of coronary heart disease based on retinal vascular caliber (from the Atherosclerosis Risk in Communities[ARIC] Study)[J].Am J Cardiol,2008,102(1):58-63. DOI:10.1016/j.amjcard.2008.02.094.
25.	谢海峰, 谢岳锐. 缺血性脑卒中患者眼底病变与颈动脉超声、颅底大动脉TCD的改变[J]. 实用心脑肺血管病杂志,2006,14(3):190-191.DOI:10.3969/j.issn.1008-5971.2006.03.011. Xie HF,Xie YR.Changes of the fundus carotids by color Doppler ultrasonography and transcranial Doppler in ischemic stroke[J].PJCCPVD,2006,14(3):190-191. DOI:10.3969/j.issn.1008-5971.2006.03.011.
26.	高颖, 韦企平. 高血压相关眼病[J].国际眼科杂志,2008,8(7):1454-1457. Gao Y,Wei QP.Hypertension related ophthalmocace[J].Int Eye Sci,2006,14(3):190-191.
27.	陈旭羚, 杨柳. 高血压视网膜病变与颈动脉病变相关性研究[J]. 中华眼底病杂志, 2016,32(3):326-330.DOI:10.3760/cma.j.issn.1005-1015.2016.03.027. Chen XL,Yang L.Research updates on the correlation of hypertensive retinopathy and carotid artery lesion[J].Chin J Ocul Fundus Dis, 2016,32(3):326-330. DOI:10.3760/cma.j.issn.1005-1015.2016.03.027.
28.	Pang Y, Sang Y, Ballew SH, et al. Carotid intima-media thickness and incident ESRD:the Atherosclerosis Risk in Communities (ARIC) Study[J/OL].Clin J Am Soc Nephrol,2016[2016-04-12].http://cjasn.asnjournals.org/content/early/2016/04/12/CJN.11951115.long. DOI:10.2215/CJN.11951115.[published online ahead of print].
29.	Talavera-Garcia E, Delgado-Lista J, Garcia-Rios A, et al. Influence of obesity and metabolic disease on carotid atherosclerosis in patients with coronary artery disease (CordioPrev Study)[J/OL].PLoS One, 2016,11(4):0153096[2016-04-11]. http://dx.doi.org/10.1371/journal.pone.0153096. DOI:10.1371/journal.Pone.0153096.
30.	Edwards MS, Wilson DB, Craven TE, et al. Associations between retinal microvascular abnormalities and declining renal function in the elderly population:the Cardiovascular Health Study[J].Am J Kidney Dis,2005,46(2):214-224.
31.	Sabanayagam C, Shankar A, Klein BEK, et al. Bidirectional association of retinal vessel diameters and estimated gfr decline:the Beaver Dam CKD Study[J]. Am J Kidney Dis,2011,57(5):682-691. DOI:10.1053/j.ajkd.2010.11.025.
32.	Klein R, Klein BE, Moss SE. The relation of systemic hypertension to changes in the retinal vasculature:the Beaver Dam Eye Study[J].Trans Am Ophthalmol Soc, 1997,95:329-348.
33.	Wong T Y, Larsen E K M, Klein R, et al.Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli:the Atherosclerosis Risk in Communities & Cardiovascular Health studies[J].Ophthalmology, 2005, 112(4):540-547.
34.	Christiansen CB,Lip GYH,Lamberts M,et al.Retinal vein and artery occlusions:a risk factor for stroke in atrial fibrillation[J].J Thromb Haemost,2013, 11(8):1485-1492. DOI:10.1111/jth.12297.
35.	García-Ortiz L, Recio-Rodríguez JI, Parra-Sanchez J, et al. A new tool to assess retinal vessel caliber. Reliability and validity of measures and their relationship with cardiovascular risk[J].J Hypertens,2012,30(4):770-777. DOI:10.1097/HJH.0b013e3283506628.
36.	Schwartz DM, Fingler J, Kim DY, et al. Phase-variance optical coherence tomography:a technique for noninvasive angiography[J].Ophthalmology,2014, 121(1):180-187. DOI:10.1016/j.ophtha.2013.09.002.
37.	Kuehlewein L, An L, Durbin MK, et al. Imaging Areas of Retinal Nonperfusion in Ischemic Branch Retinal Vein Occlusion With Swept-Source OCT Microangiography[J].Ophthalmic Surg Lasers Imaging Retina,2015,46(2):249-252. DOI:10.3928/23258160-20150213-19.
38.	Spaide RF, Jr KJ, Cooney MJ. Retinal vascular layers in macular telangiectasia type 2 imaged by optical coherence tomographic angiography[J].JAMA Ophthalmol,2015, 133(1):66-73. DOI:10.1001/jamaophthalmol.2014.3950.

1. Wong TY, Mcintosh R. Systemic associations of retinal microvascular signs:a review of recent population-based studies[J]. Ophthalmic Physiol Opt, 2005,25(3):195-204.
2. Hubbard LD, Brothers RJ, King WN, et al. Methods for evaluation of retinal microvascular abnormalities associated with hypertension/sclerosis in the atherosclerosis risk in communities study[J]. Ophthalmology, 1999, 106(12):2269-2280.
3. Liew G,Wang JJ,Cheung N,etal The retinal vasculature as a fractal:methodology,reliability,and relationship to blood pressure[J]. Ophthalmology,2008, 115(11):1951-1956. DOI:10.1016/j.ophtha.2008.05.029.
4. Cheung CY,Tay WT,Mitchell P,et al Quantitative and qualitative retinal microvascular characteristics and blood pressure[J].J Hypertens,2011,29(7):1380-1391.DOI:10.1097/HJH.0b013e328347266c.
5. Cheung CY,Thomas GN,Tay W,et al.Retinal vascular fractal dimension and its relationship with cardiovascular and ocular risk factors[J].Am J Ophthalmol,2012, 154(4):663-674.DOI:10.1016/j.ajo.2012.04.016.
6. Sng CC, Wong WL, Cheung CY, et al. Retinal vascular fractal and blood pressure in a multiethnic population[J].J Hypertens,2013,31(10):2036-2042. DOI:10.1097/HJH.0b013e328362c201.
7. Wong TY, Klein R, Sharrett AR, et al. The prevalence and risk factors of retinal microvascular abnormalities in older people:the Cardiovascular Health Study[J]. Ophthalmology, 2003, 110(4):658-666.
8. Wong TY, Klein R, Klein BEK, et al. Retinal vessel diameters and their associations with age and blood pressure[J].Invest Ophthalmol Vis Sci,2003, 44(11):4644-4650.
9. Hughes AD, Stanton AV, Jabbar AS, et al. Effect of antihypertensive treatment on retinal microvascular changes in hypertension[J].J Hypertens,2008,26(8):1703-1707. DOI:10.1097/HJH.0b013e328304b072.
10. Antonio PR, Marta PS, Luís DD, et al. Factors associated with changes in retinal microcirculation after antihypertensive treatment[J].J Hum Hypertens,2014, 28(5):310-315. DOI:10.1038/jhh.2013.108.
11. Libondi T, Jonas JB, Wang S, et al. Major eye diseases and risk factors associated with systemic hypertension in an adult chinese population:The Beijing Eye Study[J]. Ophthalmology,2009,116(12):2373-2380. DOI:10.1016/j.ophtha.2009.05.041.
12. Wong TY, Shankar A, Klein R,et al.Prospective cohort study of retinal vessel diameters and risk of hypertension[J].BMJ,2004,329(7457):79.
13. Wong TY, Klein R, Sharrett R, et al. Retinal arteriolar diameter and risk for hypertension[J].Ann Intern Med, 2004, 140(4):248-255.
14. Ikram MK, Witteman JCM, Vingerling JR, et al.Retinal vessel diameters and risk of hypertension:the Rotterdam Study[J]. Hypertension, 2006, 47(2):189-194.
15. Ding J, Wai KL, McGeechan K,et al.Retinal vascular caliber and the development of hypertension:a meta-analysis of individual participant data[J].J Hypertens, 2014,32(2):207-215. DOI:10.1097/HJH.0b013e32836586f4.
16. Wong TY, Coresh J, Klein R, et al. Retinal microvascular abnormalities and renal dysfunction:the atherosclerosis risk in communities study[J].J Am Soc Nephrol, 2004,15(9):2469-2476.
17. Amemiya T, Bhutto IA. Retinal vascular changes and systemic diseases:corrosion cast demonstration[J].Ital J Anat Embryol,2001,106(2 Suppl 1):S237-244.
18. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality:a meta-analysis of individual data for one million adults in 61 prospective studies[J]. Lancet,2002,360(9349):1903-1913.
19. Wong TY, Klein R, Nieto FJ,et al.Retinal microvascular abnormalities and 10-year cardiovascular mortality:a population-based case-control study[J]. Ophthalmology,2003,110(5):933-940.
20. Wong TY, Klein R, Couper DJ, et al. Retinal microvascular abnormalities and incident stroke:the atherosclerosis risk in communities study[J]. Lancet, 2001, 358(9288):1134-1140.
21. Mitchell P, Wang JJ, Wong TY, et al. Retinal microvascular signs and risk of stroke and stroke mortality|NOVA. The University of Newcastle's Digital Repository[J]. University of Newcastle, 2005.
22. Ikram MK, de Jong FJ, Bos MJ,et al.Retinal vessel diameters and risk of stroke:the Rotterdam Study[J].Neurology,2006,66(9):1339-1343.
23. Wong TY, McIntosh R.Hypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality[J].Br Med Bull,2005,73-74:57-70.
24. Mcgeechan K, Liew G, Macaskill P, et al. Risk prediction of coronary heart disease based on retinal vascular caliber (from the Atherosclerosis Risk in Communities[ARIC] Study)[J].Am J Cardiol,2008,102(1):58-63. DOI:10.1016/j.amjcard.2008.02.094.
25. 谢海峰, 谢岳锐. 缺血性脑卒中患者眼底病变与颈动脉超声、颅底大动脉TCD的改变[J]. 实用心脑肺血管病杂志,2006,14(3):190-191.DOI:10.3969/j.issn.1008-5971.2006.03.011. Xie HF,Xie YR.Changes of the fundus carotids by color Doppler ultrasonography and transcranial Doppler in ischemic stroke[J].PJCCPVD,2006,14(3):190-191. DOI:10.3969/j.issn.1008-5971.2006.03.011.
26. 高颖, 韦企平. 高血压相关眼病[J].国际眼科杂志,2008,8(7):1454-1457. Gao Y,Wei QP.Hypertension related ophthalmocace[J].Int Eye Sci,2006,14(3):190-191.
27. 陈旭羚, 杨柳. 高血压视网膜病变与颈动脉病变相关性研究[J]. 中华眼底病杂志, 2016,32(3):326-330.DOI:10.3760/cma.j.issn.1005-1015.2016.03.027. Chen XL,Yang L.Research updates on the correlation of hypertensive retinopathy and carotid artery lesion[J].Chin J Ocul Fundus Dis, 2016,32(3):326-330. DOI:10.3760/cma.j.issn.1005-1015.2016.03.027.
28. Pang Y, Sang Y, Ballew SH, et al. Carotid intima-media thickness and incident ESRD:the Atherosclerosis Risk in Communities (ARIC) Study[J/OL].Clin J Am Soc Nephrol,2016[2016-04-12].http://cjasn.asnjournals.org/content/early/2016/04/12/CJN.11951115.long. DOI:10.2215/CJN.11951115.[published online ahead of print].
29. Talavera-Garcia E, Delgado-Lista J, Garcia-Rios A, et al. Influence of obesity and metabolic disease on carotid atherosclerosis in patients with coronary artery disease (CordioPrev Study)[J/OL].PLoS One, 2016,11(4):0153096[2016-04-11]. http://dx.doi.org/10.1371/journal.pone.0153096. DOI:10.1371/journal.Pone.0153096.
30. Edwards MS, Wilson DB, Craven TE, et al. Associations between retinal microvascular abnormalities and declining renal function in the elderly population:the Cardiovascular Health Study[J].Am J Kidney Dis,2005,46(2):214-224.
31. Sabanayagam C, Shankar A, Klein BEK, et al. Bidirectional association of retinal vessel diameters and estimated gfr decline:the Beaver Dam CKD Study[J]. Am J Kidney Dis,2011,57(5):682-691. DOI:10.1053/j.ajkd.2010.11.025.
32. Klein R, Klein BE, Moss SE. The relation of systemic hypertension to changes in the retinal vasculature:the Beaver Dam Eye Study[J].Trans Am Ophthalmol Soc, 1997,95:329-348.
33. Wong T Y, Larsen E K M, Klein R, et al.Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli:the Atherosclerosis Risk in Communities & Cardiovascular Health studies[J].Ophthalmology, 2005, 112(4):540-547.
34. Christiansen CB,Lip GYH,Lamberts M,et al.Retinal vein and artery occlusions:a risk factor for stroke in atrial fibrillation[J].J Thromb Haemost,2013, 11(8):1485-1492. DOI:10.1111/jth.12297.
35. García-Ortiz L, Recio-Rodríguez JI, Parra-Sanchez J, et al. A new tool to assess retinal vessel caliber. Reliability and validity of measures and their relationship with cardiovascular risk[J].J Hypertens,2012,30(4):770-777. DOI:10.1097/HJH.0b013e3283506628.
36. Schwartz DM, Fingler J, Kim DY, et al. Phase-variance optical coherence tomography:a technique for noninvasive angiography[J].Ophthalmology,2014, 121(1):180-187. DOI:10.1016/j.ophtha.2013.09.002.
37. Kuehlewein L, An L, Durbin MK, et al. Imaging Areas of Retinal Nonperfusion in Ischemic Branch Retinal Vein Occlusion With Swept-Source OCT Microangiography[J].Ophthalmic Surg Lasers Imaging Retina,2015,46(2):249-252. DOI:10.3928/23258160-20150213-19.
38. Spaide RF, Jr KJ, Cooney MJ. Retinal vascular layers in macular telangiectasia type 2 imaged by optical coherence tomographic angiography[J].JAMA Ophthalmol,2015, 133(1):66-73. DOI:10.1001/jamaophthalmol.2014.3950.

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