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Adaptive optics imaging reveals structural background of hypertensive retinopathy

Session Details

Session Title: Vascular Diseases I

Session Date/Time: Friday 27/09/2013 | 08:00-10:00

Paper Time: 09:12

Venue: Hall C (Level 1)

First Author: M.Paques FRANCE

Co Author(s):    E. Koch   D. Rosenbaum   X. Girerd   J. sahel     

Abstract Details

Purpose:

Microvascular remodeling leading to parietal thickening occurs early in the course of hypertension. Hypertensive retinopathy, a surrogate of end-organ damage due to hypertension, may manifest through various clinically observable features such as generalized arteriolar narrowing and the development of focal lesions such as arteriovenous nicking (AVN) and focal arteriolar narrowing (FAN). However, current in vivo imaging systems do not allow direct observation of the arteriolar wall, which limits the clinical pertinence of fundus examination. Here , we analyzed the vascular structure of retinal vessels in a cohort of 40 subjects with various levels of blood pressure.

Setting:

Quinze-Vingts Hospital, Paris

Methods:

High resolution images of retinal arteries (inner diameter 50 to 110 µm) was performed in a cohort of 40 treatment-naive subjects (18 women and 22 men, mean age (± SD), 45.1 years ± 15; mean systolic arterial pressure 128mmHg± 21) using a flood imaging AO system. Parietal structures were automatically detected and morphometric parameters extracted using a custom-made software. The lumen diameter and wall-to-lumen ratio (WLR) was measured.

Results:

The mean WLR at the reference site was 0.309 (± 0.08). The WLR was positively correlated with systolic and diastolic blood pressure and inversely correlated to vessel diameter, but was not correlated to age or gender. In multivariate analysis taking into account age, lumen diameter, and systolic and diastolic blood pressure, only diastolic blood pressure and lumen diameter were found independently correlated to WLR (p<0.01). Parietal thickening was not the primary cause of FANs and AVNs, which showed narrowing of the outer diameter and paravascular changes, respectively.

Conclusions:

AO NIR imaging allows a unique approach of the structural background of hypertensive retinopathy. The imaging procedure is reproducible, patient-friendly and of reasonably short duration, making it potentially suitable for integration in clinical trials as well as in clinical practice.

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