title: Retinal Microvascular Calibers Are Associated With Enlarged Perivascular Spaces in the Brain.
abstract: Perivascular enlargement in the brain is a putative imaging marker for microvascular brain damage, but this link has not yet been confirmed using direct in vivo visualization of small vessels. We investigated the relation between microvascular calibers on retinal imaging and enlarged perivascular spaces (ePVSs) on brain magnetic resonance imaging.
  
  
  
  We included 704 participants from the Rotterdam study. Retinal arteriolar and venular calibers were measured semiautomatically on fundus photographs. ePVSs were counted in the centrum semiovale, basal ganglia, hippocampus, and mesencephalon, using a standardized rating method. We determined the association between retinal microvascular calibers and ePVSs with negative binomial regression models, adjusting for age, sex, the other vascular caliber, structural brain magnetic resonance imaging markers, and cardiovascular risk factors.
  
  
  
  Both narrower arteriolar and wider venular calibers were associated with more ePVSs in the centrum semiovale and hippocampal region. Rate ratios (95% confidence interval) for arterioles in the centrum semiovale and hippocampus were 1.07 (1.01-1.14) and 1.13 (1.04-1.22), respectively, and for venules 1.08 (1.01-1.16) and 1.09 (1.00-1.18), respectively. These associations were independent from other brain magnetic resonance imaging markers and cardiovascular risk factors.
  
  
  
  Retinal microvascular calibers are related to ePVSs, confirming the putative link between microvascular damage and ePVSs.
authors.affiliation: From the Departments of Epidemiology (U.M., H.H.H.A., A.H., C.C.W.K., M.W.V., M.K.I., M.A.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (H.H.H.A., A.v.d.L., M.W.V., M.A.I.), Neurology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.); and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (M.K.I.).
authors.forename: Unal
authors.initials: U
authors.lastname: Mutlu
authors.affiliation: From the Departments of Epidemiology (U.M., H.H.H.A., A.H., C.C.W.K., M.W.V., M.K.I., M.A.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (H.H.H.A., A.v.d.L., M.W.V., M.A.I.), Neurology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.); and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (M.K.I.).
authors.forename: Hieab H H
authors.initials: HH
authors.lastname: Adams
authors.affiliation: From the Departments of Epidemiology (U.M., H.H.H.A., A.H., C.C.W.K., M.W.V., M.K.I., M.A.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (H.H.H.A., A.v.d.L., M.W.V., M.A.I.), Neurology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.); and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (M.K.I.).
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: From the Departments of Epidemiology (U.M., H.H.H.A., A.H., C.C.W.K., M.W.V., M.K.I., M.A.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (H.H.H.A., A.v.d.L., M.W.V., M.A.I.), Neurology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.); and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (M.K.I.).
authors.forename: Aad van der
authors.initials: Av
authors.lastname: Lugt
authors.affiliation: From the Departments of Epidemiology (U.M., H.H.H.A., A.H., C.C.W.K., M.W.V., M.K.I., M.A.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (H.H.H.A., A.v.d.L., M.W.V., M.A.I.), Neurology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.); and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (M.K.I.).
authors.forename: Caroline C W
authors.initials: CC
authors.lastname: Klaver
authors.affiliation: From the Departments of Epidemiology (U.M., H.H.H.A., A.H., C.C.W.K., M.W.V., M.K.I., M.A.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (H.H.H.A., A.v.d.L., M.W.V., M.A.I.), Neurology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.); and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (M.K.I.).
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
authors.affiliation: From the Departments of Epidemiology (U.M., H.H.H.A., A.H., C.C.W.K., M.W.V., M.K.I., M.A.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (H.H.H.A., A.v.d.L., M.W.V., M.A.I.), Neurology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.); and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (M.K.I.).
authors.forename: M Kamran
authors.initials: MK
authors.lastname: Ikram
authors.affiliation: From the Departments of Epidemiology (U.M., H.H.H.A., A.H., C.C.W.K., M.W.V., M.K.I., M.A.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (H.H.H.A., A.v.d.L., M.W.V., M.A.I.), Neurology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.); and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (M.K.I.). m.a.ikram@erasmusmc.nl.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
mesh_terms: D000368:Aged; D001160:Arterioles / Q000000981:diagnostic imaging*; D005260:Female; D006624:Hippocampus / Q000098:blood supply* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012171:Retinal Vessels / Q000000981:diagnostic imaging*; D014699:Venules / Q000000981:diagnostic imaging*; D066127:White Matter / Q000098:blood supply* / Q000000981:diagnostic imaging*
keywords: brain; inflammation; magnetic resonance imaging; microcirculation; risk factors