Rudnicka, AR; Owen, CG; Welikala, RA; Barman, SA; Whincup, PH; Strachan, DP; Chan, MPY; ... Foster, PJ; + view all Rudnicka, AR; Owen, CG; Welikala, RA; Barman, SA; Whincup, PH; Strachan, DP; Chan, MPY; Khawaja, AP; Broadway, DC; Luben, R; Hayat, SA; Khaw, K-T; Foster, PJ; - view fewer (2020) Retinal vasculometry associations with glaucoma; findings from the European Prospective Investigation of Cancer-Norfolk Eye study. American Journal of Ophthalmology , 220 pp. 140-151. 10.1016/j.ajo.2020.07.027.

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Abstract

PURPOSE: To examine retinal vasculometry associations with different glaucomas in older British people. DESIGN: Cross-sectional study. METHODS: 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. Main Outcome Measures: 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. RESULTS: 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 mm^{2}; 95% CI −0.3 mm^{2}, −0.1 mm^{2}) and NTG (−0.2 mm^{2}; 95% CI −0.3 mm^{2}, −0.0 mm^{2}). 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. CONCLUSIONS: 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.

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