title: Carotid Atherosclerosis, Cerebrospinal Fluid Pressure, and Retinal Vessel Diameters: The Asymptomatic Polyvascular Abnormalities in Community Study.
abstract: OBJECTIVE
  To assess relationships between carotid artery atherosclerosis and retinal arteriolar and venular diameters.
  
  
  METHODS
  The community-based longitudinal Asymptomatic Polyvascular Abnormalities Community Study (APAC) included a sub-population of the Kailuan study which consisted of 101,510 employees and retirees of a coal mining industry. Based on the Chinese National Census 2010 and excluding individuals with history of cerebrovascular ischemic events, 4004 individuals were included into the APAC. All participants underwent a detailed clinical examination including blood laboratory tests and carotid artery duplex ultrasound examination. The cerebrospinal fluid pressure (CSFP) was estimated using the formula: CSFP[mmHg] = 0.44xBody Mass Index[kg/m2]+0.16xDiastolic Blood Pressure[mmHg]-0.18 x Age[Years]-1.91.
  
  
  RESULTS
  In multivariable analysis (goodness of fit r2:0.12), thicker retinal arteries were associated with a thinner common carotid artery intima-media thickness (IMT) (P = 0.002; standardized regression coefficient beta:-0.06; non-standardized regression coefficient B:-6.92;95% confidence interval (CI):-11.2,-2.61) after adjusting for thicker retinal nerve fiber layer (P<0.001;beta:0.18;B:0.35;95%CI:0.28,0.42), lower diastolic blood pressure (P<0.001;beta:-0.16;B:-0.17;95%CI:-0.21,-0.3), younger age (P<0.001;beta:-0.08; B:-0.16;95%;CI:-0.25,-0.08), and less abdominal circumference (P = 0.003;beta:-0.06;B:-0.11;95%CI:-0.18,-0.03). Thicker retinal vein diameter was associated (r = 0.40) with higher estimated CSFP (P<0.001;beta:0.09;B:0.78;95%CI:0.47,1.08) after adjusting for wider retinal arteries (P<0.001;beta:0.27;B:0.36;95%CI:0.31,0.41), thicker retinal nerve fiber layer thickness (P = 0.03;beta:0.22;B:0.56;95%CI:0.46,0.65) and male gender (P<0.001;beta:-0.08;B:-3.98;95%CI:-5.88,2.09).
  
  
  CONCLUSIONS
  Thinner retinal artery diameter was significantly, however weakly, associated with increased common carotid artery IMT. It suggests that retinal microvascular changes were only week indicators for an atherosclerotic carotid artery pathology. Thicker retinal vein diameter was associated with higher estimated CSFP, confirming associations between higher estimated CSFP and higher incidence of retinal vein occlusion.
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China.
authors.forename: Jing Yan
authors.initials: JY
authors.lastname: Yang
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Yang
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
authors.forename: An Xin
authors.initials: AX
authors.lastname: Wang
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America.|Department of Nutritional Sciences, The Pennsylvania State University, Department of Nutritional Sciences, University Park, Pennsylvania, United States of America.
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
authors.affiliation: Beijing Institute of Ophthalmology, Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan, China.
authors.forename: Shou Ling
authors.initials: SL
authors.lastname: Wu
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China.
authors.forename: Wen Bin
authors.initials: WB
authors.lastname: Wei
authors.affiliation: Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xing Quan
authors.initials: XQ
authors.lastname: Zhao
authors.affiliation: Beijing Institute of Ophthalmology, Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.|Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht- Karls-University, Mannheim, Germany.
authors.forename: Jost B
authors.identifier: http://orcid.org/0000-0003-2972-5227
authors.initials: JB
authors.lastname: Jonas
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D001794:Blood Pressure; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D015170:Cerebrospinal Fluid Pressure; D003154:Community Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012160:Retina / Q000000981:diagnostic imaging / Q000473:pathology; D012161:Retinal Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D012169:Retinal Vein / Q000000981:diagnostic imaging*; D012170:Retinal Vein Occlusion / Q000000981:diagnostic imaging* / Q000473:pathology; D014699:Venules / Q000000981:diagnostic imaging / Q000473:pathology