Semi-automatic measuring of arteriovenous relation as a possible silent brain infarction risk index in hypertensive patients

Abstract

Objective: To evaluate the usefulness of a semiautomatic measuring system of arteriovenous relation (RAV) from retinographic images of hypertensive patients in assessing their cardiovascular risk and silent brain ischemia (ICS) detection.

Methods: Semi-automatic measurement of arterial and venous width were performed with the aid of Imedos software and conventional fundus examination from the analysis of retinal images belonging to the 976 patients integrated in the cohort Investigating Silent Strokes in Hypertensives: a magnetic resonance imaging study (ISSYS), group of hypertensive patients. All patients have been subjected to a cranial magnetic resonance imaging (RMN) to assess the presence or absence of brain silent infarct.

Results: Retinal images of 768 patients were studied. Among the clinical findings observed, association with ICS was only detected in patients with microaneurysms (OR 2.50; 95% CI: 1.05-5.98) or altered RAV (<0.666) (OR: 4.22; 95% CI: 2.56-6.96). In multivariate logistic regression analysis adjusted by age and sex, only altered RAV continued demonstrating as a risk factor (OR: 3.70; 95% CI: 2.21-6.18).

Conclusions: The results show that the semiautomatic analysis of the retinal vasculature from retinal images has the potential to be considered as an important vascular risk factor in hypertensive population.

Keywords: Arterial hypertension; Arteriole to venule ratio; Eye fundus; Fondo de ojo; Hipertensión arterial; Ictus; Isquemia cerebral silente; Medición semiautomática de la microcirculación retiniana; Ratio arteria vena; Retinografía; Retinography; Retinopathy; Retinopatía; Semi-automatic retinal vessel quantification; Silent brain infarct; Stroke.