title: Evidence of Microvascular Changes in the Retina following Kawasaki Disease.
abstract: It is unclear whether all children with Kawasaki disease (KD) have increased later cardiovascular risk. The retinal microvasculature reflects changes in the microcirculation and is associated with traditional cardiovascular risk factors and events. The aim of this study was to investigate retinal microvascular parameters in two populations of patients with previous KD and control participants. We performed case-control studies of 116 (57 patients and 59 control participants) Australian and 156 (78 patients and 78 control participants) Singaporean individuals, at least two years since their acute illness. Standardised retinal photographs were graded by trained technicians using a semi-automated software, which quantifies the retinal microvasculature (calibre, branching angle, fractal dimensions, and tortuosity). Retinal venules of Singaporean KD patients were 9.67 μm (95% CI 4.87 to 14.51, p < 0.001) larger than control participants following correction for traditional cardiovascular risk factors. An incremental increase in the size of retinal venules in those with coronary artery abnormalities was observed. There was limited evidence that retinal venules were larger in Australian KD patients with coronary artery abnormalities compared to control participants (7.34 μm, 95% CI 1.30 to 15.99, p = 0.10). Differences in retinal microvasculature were particularly evident in Singaporean KD patients. Larger retinal venules may reflect chronic inflammation and endothelial dysfunction, and are associated with coronary artery disease in adults.
authors.affiliation: Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Vic, Australia.|Department of Paediatrics, University of Melbourne, Vic, Australia.|Infectious Diseases Unit and Department of General Medicine, The Royal Children's Hospital Melbourne, Vic, Australia.
authors.forename: Katherine Y H
authors.initials: KY
authors.lastname: Chen
authors.affiliation: Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Vic, Australia.|Department of Paediatrics, University of Melbourne, Vic, Australia.|Department of Paediatrics, Monash University, Vic, Australia.
authors.forename: David P
authors.initials: DP
authors.lastname: Burgner
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Duke-NUS Medical School, National University of Singapore, Singapore.
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Duke-NUS Medical School, National University of Singapore, Singapore.
authors.forename: Seang Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
authors.forename: Swee Chye
authors.initials: SC
authors.lastname: Quek
authors.affiliation: Department of Ophthalmology, Tan Tock Seng Hospital, Singapore.
authors.forename: Audrey Y C
authors.initials: AY
authors.lastname: Pang
authors.affiliation: Dr Leo Adult &Paediatric Eye Specialist, Mount Elizabeth Hospital, Singapore.
authors.forename: Seo Wei
authors.initials: SW
authors.lastname: Leo
authors.affiliation: Department of Ophthalmology, National University Health System, Singapore.
authors.forename: Inez B
authors.initials: IB
authors.lastname: Wong
authors.affiliation: Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Vic, Australia.
authors.forename: Diana
authors.initials: D
authors.lastname: Zannino
authors.affiliation: Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Vic, Australia.|Department of Paediatrics, University of Melbourne, Vic, Australia.|Infectious Diseases Unit and Department of General Medicine, The Royal Children's Hospital Melbourne, Vic, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Curtis
authors.affiliation: Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Vic, Australia.|Department of Paediatrics, University of Melbourne, Vic, Australia.|Heart Research Group, Murdoch Childrens Research Institute and Department of Cardiology, The Royal Children's Hospital, Melbourne, Vic, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Cheung
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Carol Y
authors.initials: CY
authors.lastname: Cheung
authors.affiliation: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
authors.forename: Terence C W
authors.initials: TC
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000473:pathology*; D012160:Retina / Q000473:pathology*; D012171:Retinal Vessels / Q000473:pathology*; D012307:Risk Factors; D055815:Young Adult