北京市40岁以上中老年人群视网膜血管分形维度的横断面调查
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摘要
目的定量描述北京市40岁及以上人群视网膜血管分形维度及其年龄、性别分布。设计横断面研究。研究对象 "北京眼病研究"基线人群。方法采用定量测量软件(SIVA3.0)对3901例受检者随机一眼的彩色眼底照片中的视网膜血管分形维度指标进行测量。测量分区:距视盘边缘0.5～1 PD之间的环形区域为B区,距视盘边缘0.5～2 PD之间的环形区域为C区。主要指标视网膜血管分形维度(RVDf)、视网膜动脉分形维度(RVDfa)、视网膜静脉分形维度(RVDfv)。结果本研究中3901例40岁以上中老年人群的RVDf、RVDfa和RVDfv分别为1.37±0.04、1.15±0.05和1.16±0.05。不同年龄组间的RVDf、RVDfa、RVDfv有明显差异,随年龄增长逐渐变小(P均<0.001)。不同性别间的RVDf无明显差异(P=0.83),但RVDfa和RVDfv则差异明显。男性的RVDfv比女性大(P<0.001),RVDfa则小于女性(P=0.03)。多因素分析结果表明,RVDf与高血压(r=-0.001, P=0.047)相关,RVDfa与BMI(r=-0.001, P<0.0001)相关,RVDfv与BMI(r=0.0008, P=0.001)和饮酒(r=0.0025, P=0.028)相关。结论北京市40岁以上人群中,视网膜血管分形维度随年龄增长逐渐下降,年龄越大,其视网膜血管的分形维度越小,血管密度越稀疏,血管的分支模式越简单。此外,男性的静脉分形维度比女性大,动脉分形维度则比女性稍小。
Objective To quantitatively assess the retinal vascular fractal dimension and its associations in an elderly population in Beijing. Design Cross-sectional study. Participants Baseline population of Beijing Eye Study. Methods Quantitative measurement software(Singapore I Vessel Assessment, SIVA 3.0) was used to measure the parameters of retinal vascular fractal dimension on zone B and zone C in color fundus photographs from 3901 subjects. One eye of each participant was randomly selected. The region from 0.5 to1 PD away from the disc margin was zone B, and 0.5～2 PD away from the disc margin was zone C. Main Outcome Measures Retinal vascular fractal dimension(RVDf), fractal dimension arteriole(RVDfa), fractal dimension venule(RVDfv). Results In this study, the RVDf, RVDfa and RVDfv of 3901 elderly people was 1.37±0.04, 1.15±0.05 and 1.16±0.05 respectively. The RVDf, RVDfa and RVDfv in different age groups were significantly different(all P<0.001). These parameters gradually decreased with age. There was no significant difference in RVDf between different genders(P=0.83), but RVDfa and RVDfv were significantly different. Men's RVDfv was larger than women's(P<0.001). RVDfa was smaller in men than in women(P=0.03). Multivariate analysis showed that RVDf was significantly associated with hypertension(r=-0.001, P=0.047). RVDfa was significantly associated with BMI(r=-0.001, P<0.0001). RVDfv was significantly associated with BMI(r=0.0008, P=0.001) and drinking habit(r= 0.0025, P=0.028). Conclusion Retinal vascular fractal dimension gradually decreased with age in elderly population in Beijing. The density of retinal vessels decreased with age as well. Men's RVDfv was larger than women's, but RVDfa was a little smaller in men than in women.
Objective To quantitatively assess the retinal vascular fractal dimension and its associations in an elderly population in Beijing. Design Cross-sectional study. Participants Baseline population of Beijing Eye Study. Methods Quantitative measurement software(Singapore I Vessel Assessment, SIVA 3.0) was used to measure the parameters of retinal vascular fractal dimension on zone B and zone C in color fundus photographs from 3901 subjects. One eye of each participant was randomly selected. The region from 0.5 to1 PD away from the disc margin was zone B, and 0.5～2 PD away from the disc margin was zone C. Main Outcome Measures Retinal vascular fractal dimension(RVDf), fractal dimension arteriole(RVDfa), fractal dimension venule(RVDfv). Results In this study, the RVDf, RVDfa and RVDfv of 3901 elderly people was 1.37±0.04, 1.15±0.05 and 1.16±0.05 respectively. The RVDf, RVDfa and RVDfv in different age groups were significantly different(all P<0.001). These parameters gradually decreased with age. There was no significant difference in RVDf between different genders(P=0.83), but RVDfa and RVDfv were significantly different. Men's RVDfv was larger than women's(P<0.001). RVDfa was smaller in men than in women(P=0.03). Multivariate analysis showed that RVDf was significantly associated with hypertension(r=-0.001, P=0.047). RVDfa was significantly associated with BMI(r=-0.001, P<0.0001). RVDfv was significantly associated with BMI(r=0.0008, P=0.001) and drinking habit(r= 0.0025, P=0.028). Conclusion Retinal vascular fractal dimension gradually decreased with age in elderly population in Beijing. The density of retinal vessels decreased with age as well. Men's RVDfv was larger than women's, but RVDfa was a little smaller in men than in women.
引文
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[3] Cheung CY, Tay WT, Ikram MK, et al. Retinal microvascular changes and risk of stroke:the Singapore Malay Eye Study. Stroke,2013, 44(9):2402-2408.
[4] Bek T. Diameter changes of retinal vessels in diabetic retinopathy.Curr Diab Rep, 2017, 17(10):82.
[5] Al-Fiadh AH, Farouque O, Kawasaki R, et al. Retinal microvascular structure and function in patients with risk factors of atherosclerosis and coronary artery disease. Atherosclerosis, 2014, 233(2):478-484.
[6] Rhee EJ, Chung PW, Wong TY, et al. Relationship of retinal vascular caliber variation with intracranial arterial stenosis. Microvasc Res, 2016, 108(1):64-68.
[7] Mutlu U, Ikram MK, Wolters FJ, et al. Retinal microvasculature is associated with long-term survival in the general adult dutch population. Hypertension, 2016, 67(2):281-287.
[8] Newman AR, Andrew NH, Casson RJ. Review of paediatric retinal microvascular changes as a predictor of cardiovascular disease. Clin Exp Ophthalmol, 2017, 45(1):33-44.
[9]王爽,魏串串,刘雪,等.北京市40岁以上中老年人群视网膜血管直径的横断面调查.眼科, 2018, 27(4):246-253.
[10] Cheung CY, Tay WT, Mitchell P, et al. Quantitative and qualitative retinal microvascular characteristics and blood pressure. J Hypertens, 2011, 29(7):1380-1391.
[11] Liew G, Wang JJ, Cheung N, et al. The retinal vasculature as a fractal:methodology, reliability, and relationship to blood pressure. Ophthalmology, 2008, 115(11):1951-1956.
[12] Palsson O, Geirsdottir A, Hardarson SH, et al. Retinal oximetry images must be standardized:a methodological analysis. Invest Ophthalmol Vis Sci, 2012, 53(4):1729-1733.
[13] Frangieh GT, Green WR, Barraquer-Somers E, et al. Histopathologic study of nine branch retinal vein occlusions. Arch Ophthalmol, 1982, 100(7):1132-1140.
[14] Littmann H. Determination of the real size of an object on the fundus of the living eye. Klin Monbl Augenheilkd, 1982, 180(4):286-289.
[15] Jonas JB, Tao Y, Neumaier M, et al. VEGF and refractive error.Ophthalmology, 2010, 117(11):2234.
[16] Mohan A, Dabir S, Yadav NK, et al. Normative database of retinal oximetry in asian Indian eyes. PLoS One, 2015, 10(4):e0126179.
[17] Ikram MK, Witteman JC, Vingerling JR, et al. Retinal vessel diameters and risk of hypertension:the Rotterdam Study. Hypertension, 2006, 47(2):189-194.
[18] Kawasaki R, Cheung N, Wang JJ, et al. Retinal vessel diameters and risk of hypertension:the Multiethnic Study of Atherosclerosis.J Hypertens, 2009, 27(12):2386-2393.
[19] Ong YT, Wong TY, Klein R, et al. Hypertensive retinopathy and risk of stroke. Hypertension, 2013, 62(4):706-711.
[20] Wong TY, Klein R, Sharrett AR, et al. Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study. JAMA, 2002, 287(9):1153-1159.
[21] Coll-de-Tuero G, Gonzalez-Vazquez S, Rodriguez-Poncelas A, et al.Retinal arteriole-to-venule ratio changes and target organ disease evolution in newly diagnosed hypertensive patients at 1-year follow-up. J Am Soc Hypertens, 2014, 8(2):83-93.
[22] Murray CD. The Physiological Principle of Minimum Work I. The Vascular System and the Cost of Blood Volume. Proc Natl Acad Sci U S A, 1926, 12(3):207-214.
[2] Konstantinidis L, Guex-Crosier Y. Hypertension and the eye. Curr Opin Ophthalmol, 2016, 27(6):514-521.
[3] Cheung CY, Tay WT, Ikram MK, et al. Retinal microvascular changes and risk of stroke:the Singapore Malay Eye Study. Stroke,2013, 44(9):2402-2408.
[4] Bek T. Diameter changes of retinal vessels in diabetic retinopathy.Curr Diab Rep, 2017, 17(10):82.
[5] Al-Fiadh AH, Farouque O, Kawasaki R, et al. Retinal microvascular structure and function in patients with risk factors of atherosclerosis and coronary artery disease. Atherosclerosis, 2014, 233(2):478-484.
[6] Rhee EJ, Chung PW, Wong TY, et al. Relationship of retinal vascular caliber variation with intracranial arterial stenosis. Microvasc Res, 2016, 108(1):64-68.
[7] Mutlu U, Ikram MK, Wolters FJ, et al. Retinal microvasculature is associated with long-term survival in the general adult dutch population. Hypertension, 2016, 67(2):281-287.
[8] Newman AR, Andrew NH, Casson RJ. Review of paediatric retinal microvascular changes as a predictor of cardiovascular disease. Clin Exp Ophthalmol, 2017, 45(1):33-44.
[9]王爽,魏串串,刘雪,等.北京市40岁以上中老年人群视网膜血管直径的横断面调查.眼科, 2018, 27(4):246-253.
[10] Cheung CY, Tay WT, Mitchell P, et al. Quantitative and qualitative retinal microvascular characteristics and blood pressure. J Hypertens, 2011, 29(7):1380-1391.
[11] Liew G, Wang JJ, Cheung N, et al. The retinal vasculature as a fractal:methodology, reliability, and relationship to blood pressure. Ophthalmology, 2008, 115(11):1951-1956.
[12] Palsson O, Geirsdottir A, Hardarson SH, et al. Retinal oximetry images must be standardized:a methodological analysis. Invest Ophthalmol Vis Sci, 2012, 53(4):1729-1733.
[13] Frangieh GT, Green WR, Barraquer-Somers E, et al. Histopathologic study of nine branch retinal vein occlusions. Arch Ophthalmol, 1982, 100(7):1132-1140.
[14] Littmann H. Determination of the real size of an object on the fundus of the living eye. Klin Monbl Augenheilkd, 1982, 180(4):286-289.
[15] Jonas JB, Tao Y, Neumaier M, et al. VEGF and refractive error.Ophthalmology, 2010, 117(11):2234.
[16] Mohan A, Dabir S, Yadav NK, et al. Normative database of retinal oximetry in asian Indian eyes. PLoS One, 2015, 10(4):e0126179.
[17] Ikram MK, Witteman JC, Vingerling JR, et al. Retinal vessel diameters and risk of hypertension:the Rotterdam Study. Hypertension, 2006, 47(2):189-194.
[18] Kawasaki R, Cheung N, Wang JJ, et al. Retinal vessel diameters and risk of hypertension:the Multiethnic Study of Atherosclerosis.J Hypertens, 2009, 27(12):2386-2393.
[19] Ong YT, Wong TY, Klein R, et al. Hypertensive retinopathy and risk of stroke. Hypertension, 2013, 62(4):706-711.
[20] Wong TY, Klein R, Sharrett AR, et al. Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study. JAMA, 2002, 287(9):1153-1159.
[21] Coll-de-Tuero G, Gonzalez-Vazquez S, Rodriguez-Poncelas A, et al.Retinal arteriole-to-venule ratio changes and target organ disease evolution in newly diagnosed hypertensive patients at 1-year follow-up. J Am Soc Hypertens, 2014, 8(2):83-93.
[22] Murray CD. The Physiological Principle of Minimum Work I. The Vascular System and the Cost of Blood Volume. Proc Natl Acad Sci U S A, 1926, 12(3):207-214.