Associations of Retinal Microvascular Density and Fractal Dimension with Glaucoma: A Prospective Study from UK Biobank.
Chen Qi, Miao Suyu, Jiang Yuzhe, Shi Danli, You Weiyun, Liu Lin, Yusufu Mayinuer, Chen Yufan, Wang Ruobing
AI Summary
This study found that lower retinal vascular density and fractal dimension, measured from fundus photos, are significantly associated with an increased risk of developing glaucoma. This suggests potential for early glaucoma risk assessment.
Abstract
Objective
To explore the association between retinal microvascular parameters and glaucoma.
Design
Prospective study.
Subjects
The UK Biobank subjects with fundus images and without a history of glaucoma.
Methods
We employed the Retina-based Microvascular Health Assessment System to utilize the noninvasive nature of fundus photography and quantify retinal microvascular parameters including retinal vascular skeleton density (VSD) and fractal dimension (FD). We also utilized propensity score matching (PSM) to pair individuals with glaucoma and healthy controls. Propensity score matching was implemented via a logistic regression model with a caliper of 0.1 and a matching ratio of 1:4 no replacements. We conducted univariable Cox regression analyses to study the association between retinal microvascular parameters and incident glaucoma, in both continuous and quartile forms.
Main outcome measure: Vascular skeleton density, FD, and glaucoma.
Results
In a study of 41 632 participants without prior glaucoma, 482 cases of glaucoma were recorded during a median follow-up of 11.0 years. In the Cox proportional hazards regression model post-PSM, we found that incident glaucoma has significant negative associations with arteriolar VSD (hazard ratio [HR] = 0.24, 95% confidence interval [CI] 0.11-0.52, P < 0.001), venular VSD (HR = 0.34, 95% CI 0.15-0.74, P = 0.007), arteriolar FD (HR = 0.24, 95% CI 0.10-0.60, P = 0.002), and venular FD (HR = 0.31, 95% CI 0.12-0.85, P = 0.022). Subgroup analysis using covariates revealed that individuals aged ≥60 years, nonsmokers, moderate alcohol consumers, and those with hypertension and myopia exhibited P values <0.05 consistently prematching and postmatching, differing from other subgroups within this covariate.
Conclusions
Our study found that reduced retinal VSD and lower FD are linked to elevated glaucoma risk.
Financial disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Shields Classification
Key Concepts6
Incident glaucoma has a significant negative association with arteriolar vascular skeleton density (VSD) (hazard ratio [HR] = 0.24, 95% confidence interval [CI] 0.11-0.52, P < 0.001) in a Cox proportional hazards regression model post-propensity score matching (PSM) in 41,632 participants from the UK Biobank.
Incident glaucoma has a significant negative association with venular vascular skeleton density (VSD) (HR = 0.34, 95% CI 0.15-0.74, P = 0.007) in a Cox proportional hazards regression model post-propensity score matching (PSM) in 41,632 participants from the UK Biobank.
Incident glaucoma has a significant negative association with arteriolar fractal dimension (FD) (HR = 0.24, 95% CI 0.10-0.60, P = 0.002) in a Cox proportional hazards regression model post-propensity score matching (PSM) in 41,632 participants from the UK Biobank.
Incident glaucoma has a significant negative association with venular fractal dimension (FD) (HR = 0.31, 95% CI 0.12-0.85, P = 0.022) in a Cox proportional hazards regression model post-propensity score matching (PSM) in 41,632 participants from the UK Biobank.
Reduced retinal vascular skeleton density (VSD) and lower fractal dimension (FD) are linked to elevated glaucoma risk in a prospective study of 41,632 participants from the UK Biobank.
In a prospective study of 41,632 participants from the UK Biobank without prior glaucoma, 482 cases of glaucoma were recorded during a median follow-up of 11.0 years.
Related Articles5
Racial-ethnic disparities in concurrent rates of peripapillary & macular OCT parameters among a large glaucomatous clinical population.
Cohort StudySocial history and glaucoma progression: the effect of body mass index, tobacco and alcohol consumption on the rates of structural change in patients with glaucoma.
Cohort StudyTime to Glaucoma Progression Detection by Optical Coherence Tomography in Individuals of African and European Descents.
Cohort StudyOcular blood flow as a clinical observation: Value, limitations and data analysis.
ReviewComparison of Deep Learning and Clinician Performance for Detecting Referable Glaucoma from Fundus Photographs in a Safety Net Population.
Cohort StudyIs this article assigned to the wrong chapter(s)? Let us know.