title: A retinal snap shot may indicate individual risk for cardiovascular disease - the MIPH Eye&Health Study.
abstract: BACKGROUND
  Examination of retinal vasculature can be used to non-invasively quantify changes within the microvasculature of the human body and might be a predictor of cardiovascular disease. This study evaluates associations of the structure of the retinal vasculature with established risk factors for cardiovascular disease.
  
  
  METHODS
  A cross-sectional study was performed in a working age population. Several systemic cardiovascular parameters were analyzed and PROCAM- and SCORE-risk estimates were calculated. A quantitative ophthalmological examination including digital fundus imaging has taken place. Central retinal arterial/venous equivalents (CRAE/CRVE) and arterio-venous ratio (AVR) were analyzed using validated software. Associations of retinal vessel parameters and systemic cardiovascular and ocular parameters were calculated by multivariate analysis using SPSS software. A p-value of <0.05 with Bonferroni correction was accepted as significant.
  
  
  RESULTS
  338 probands were included. A smaller CRAE was independently associated with increased mean arterial blood pressure, higher age and higher body-mass index. Regarding CRVE age was inversely associated. Other cardiovascular risk parameters were not associated to the examined retinal vessel equivalents. AVR showed a significant association to mean arterial blood pressure and body-mass-index. PROCAM- and SCORE-risk estimates were negatively associated with CRAE and AVR, but not associated to CRVE.
  
  
  CONCLUSIONS
  Arterial retinal vessel analysis and AV-ratio showed associations to established cardiovascular parameters in the study population. PROCAM- and SCORE-risk estimates as indicators of cardiovascular risk were associated with the CRAE and the AV-ratio. This suggests that a single snap shot of the retinal vessels may indicate the individual relative risk for cardiovascular events.
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Alexander Karl-Georg
authors.initials: AK
authors.lastname: Schuster
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Joachim Ernst
authors.initials: JE
authors.lastname: Fischer
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Ophthalmology, Mainz University Hospitals, Mainz, Germany. Electronic address: urs.vossmerbaeumer@gmx.de.
authors.forename: Urs
authors.initials: U
authors.lastname: Vossmerbaeumer
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D012171:Retinal Vessels / Q000473:pathology* / Q000503:physiopathology; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
keywords: AV-ratio; Cardiovascular risk factor; Fundus photography; PROCAM; Refraction; Retinal vessel; SCORE