title: Review of paediatric retinal microvascular changes as a predictor of cardiovascular disease.
abstract: Recent studies have supported the hypothesis that exposure to established cardiovascular risk factors in early life predisposes to the development of adult cardiovascular disease. Retinal imaging is an emerging technique which facilitates non-invasive, accurate and reproducible assessment of the retinal microvasculature. The assessment may be in the form of static vascular calibre measurements and assessment of the vascular geometry or dynamic structural and functional assessments. Paediatric retinal microvascular changes are reported in response to elevated blood pressure, type 1 diabetes, increasing adiposity, diet, physical activity, systemic inflammation, metabolic peptides, family history and prenatal factors. The resultant microvascular changes have been linked to sub-clinical and overt cardiovascular, cerebrovascular and metabolic disease states in the adult population. Still missing however is longitudinal evidence showing the persistence of retinal microvascular alterations into adulthood. Future studies will enable retinal microvascular assessment to further evaluate the pathogenesis of disease states and response to intervention. The data obtained will also aid in expanding the clinical utility of retinal imaging as a cardiovascular risk prediction and monitoring tool and supplement existing recommendations to reduce cardiovascular morbidity and mortality.
authors.affiliation: South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Newman
authors.affiliation: South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Nicholas H
authors.initials: NH
authors.lastname: Andrew
authors.affiliation: South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Casson
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D018450:Disease Progression; D014943:Global Health; D006801:Humans; D008833:Microcirculation; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D012171:Retinal Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012307:Risk Factors
keywords: arteriole; paediatric ophthalmology; retinal imaging; retinal vessel diameter; venule