title: Retinal microvasculature and white matter microstructure: The Rotterdam Study.
abstract: OBJECTIVE
  To investigate whether retinal microvascular damage is related to normal-appearing white matter microstructure on diffusion tensor MRI.
  
  
  METHODS
  We included 2,436 participants (age ≥45 years) from the population-based Rotterdam Study (2005-2009) who had gradable retinal images and brain MRI scans. Retinal arteriolar and venular calibers were measured semiautomatically on fundus photographs. White matter microstructure was assessed using diffusion tensor MRI. We used linear regression models to investigate the associations of retinal vascular calibers with markers of normal-appearing white matter microstructure, adjusting for age, sex, the fellow vascular caliber, and additionally for structural MRI markers and cardiovascular risk factors.
  
  
  RESULTS
  Narrower arterioles and wider venules were associated with poor white matter microstructure: adjusted difference in fractional anisotropy per SD decrease in arteriolar caliber -0.061 (95% confidence interval -0.106 to -0.016), increase in venular caliber -0.054 (-0.096 to -0.011), adjusted difference in mean diffusivity per SD decrease in arteriolar caliber 0.048 (0.007-0.088), and increase in venular caliber 0.047 (0.008-0.085). The associations for venules were more prominent in women.
  
  
  CONCLUSIONS
  Retinal vascular calibers are related to normal-appearing white matter microstructure. This suggests that microvascular damage in the white matter is more widespread than visually detectable as white matter lesions.
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Unal
authors: U
authors: Mutlu
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Lotte G M
authors: LG
authors: Cremers
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Marius
authors: M
authors: de Groot
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Albert
authors: A
authors: Hofman
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Wiro J
authors: WJ
authors: Niessen
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Aad
authors: A
authors: van der Lugt
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Caroline C W
authors: CC
authors: Klaver
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA. m.a.ikram@erasmusmc.nl.
authors: M Arfan
authors: MA
authors: Ikram
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Meike W
authors: MW
authors: Vernooij
authors: From the Departments of Epidemiology (U.M., L.G.M.C., A.H., C.C.W.K., M.A.I., M.W.V., M.K.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (L.G.M.C., M.d.G., W.J.N., A.v.d.L., M.A.I., M.W.V.), Medical Informatics (M.d.G., W.J.N.), and Neurology (M.A.I., M.K.I.), Erasmus University Medical Center, Rotterdam; Department of Imaging Science and Technology (M.d.G., W.J.N.), Faculty of Applied Sciences, Delft University of Technology, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
authors: M Kamran
authors: MK
authors: Ikram
mesh_terms: D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010363:Pattern Recognition, Automated; D011446:Prospective Studies; D012160:Retina / Q000000981:diagnostic imaging*; D012171:Retinal Vessels / Q000000981:diagnostic imaging*; D066127:White Matter / Q000098:blood supply* / Q000000981:diagnostic imaging*