title: Retinal arteriolar remodeling evaluated with adaptive optics camera: Relationship with blood pressure levels.
abstract: OBJECTIVE
  To research a retinal arterioles wall-to-lumen ratio or lumen diameter cut-off that would discriminate hypertensive from normal subjects using adaptive optics camera.
  
  
  METHODS
  One thousand and five hundred subjects were consecutively recruited and Adaptive Optics Camera rtx1™ (Imagine-Eyes, Orsay, France) was used to measure wall thickness, internal diameter, to calculate wall-to-lumen ratio (WLR) and wall cross-sectional area of retinal arterioles. Sitting office blood pressure was measured once, just before retinal measurements and office blood pressure was defined as systolic blood pressure>=140mmHg and diastolic blood pressure>=90mmHg. ROC curves were constructed to determine cut-off values for retinal parameters to diagnose office hypertension. In another population of 276 subjects office BP, retinal arterioles evaluation and home blood pressure monitoring were obtained. The applicability of retinal WLR or diameter cut-off values were compared in patients with controlled, masked, white-coat and sustained hypertension.
  
  
  RESULTS
  In 1500 patients, a WLR>0.31 discriminated office hypertensive subjects with a 0.57 sensitivity and 0.71 specificity. Lumen diameter<78.2μm discriminated office hypertension with a 0.73 sensitivity and a 0.52 specificity. In the other 276 patients, WLR was higher in sustained hypertension vs normotensive patients (0.330±0.06 vs 0.292±0.05; P<0.001) and diameter was narrower in masked hypertensive vs normotensive subjects (73.0±11.2 vs 78.5±11.6μm; P<0.005).
  
  
  CONCLUSIONS
  A WLR higher than 0.31 is in favour of office arterial hypertension; a diameter under<78μm may indicate a masked hypertension. Retinal arterioles analysis through adaptive optics camera may help the diagnosis of arterial hypertension, in particular in case of masked hypertension.
authors.affiliation: Preventive Cardiovascular Unit, Institute of Cardiometabolism and Nutrition, Unité de Prévention Cardiovasculaire, Service d'Endocrinologie Métabolisme, Groupe Hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Sorbonne Universités, UPMC Université Paris 06, Inserm 1146,-CNRS 7371, Laboratoire d'imagerie biomédicale, 75013 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Gallo
authors.affiliation: Preventive Cardiovascular Unit, Institute of Cardiometabolism and Nutrition, Unité de Prévention Cardiovasculaire, Service d'Endocrinologie Métabolisme, Groupe Hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Sorbonne Universités, UPMC Université Paris 06, Inserm 1146,-CNRS 7371, Laboratoire d'imagerie biomédicale, 75013 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Mattina
authors.affiliation: Preventive Cardiovascular Unit, Institute of Cardiometabolism and Nutrition, Unité de Prévention Cardiovasculaire, Service d'Endocrinologie Métabolisme, Groupe Hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Sorbonne Universités, UPMC Université Paris 06, Inserm 1146,-CNRS 7371, Laboratoire d'imagerie biomédicale, 75013 Paris, France; Imaging Core Lab, Institute of Cardiometabolism and Nutrition, ICAN, 75013 Paris, France. Electronic address: david.rosenbaum@aphp.fr.
authors.forename: D
authors.initials: D
authors.lastname: Rosenbaum
authors.affiliation: Unité Inserm 968, Institut de la vision - Centre d'Investigation Clinique 503, Centre Hospitalier National des Quinze-Vingts, Assistance publique-Hôpitaux de Paris, 75012 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Koch
authors.affiliation: Unité Inserm 968, Institut de la vision - Centre d'Investigation Clinique 503, Centre Hospitalier National des Quinze-Vingts, Assistance publique-Hôpitaux de Paris, 75012 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Paques
authors.affiliation: Preventive Cardiovascular Unit, Institute of Cardiometabolism and Nutrition, Unité de Prévention Cardiovasculaire, Service d'Endocrinologie Métabolisme, Groupe Hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
authors.forename: X
authors.initials: X
authors.lastname: Girerd
mesh_terms: D001160:Arterioles / Q000473:pathology; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D015992:Body Mass Index; D003941:Diagnostic Techniques, Ophthalmological; D005602:France; D006801:Humans; D006973:Hypertension / Q000473:pathology; D009898:Optic Disk / Q000098:blood supply*; D010781:Photography / Q000295:instrumentation*; D011237:Predictive Value of Tests; D012161:Retinal Artery / Q000473:pathology*; D012164:Retinal Diseases / Q000473:pathology*; D012307:Risk Factors; D012680:Sensitivity and Specificity
keywords: Adaptive optics camera; High blood pressure; Hypertension artérielle; Hypertension masquée; Masked hypertension; Optique adaptative; Remodelage artériolaire; Retinal microcirculation; Vascularisation rétinienne; Wall-to-lumen ratio