Retinal Microvascular Abnormalities and their Relationship with Hypertension, Cardiovascular Disease, and Mortality

Wong, Tien Yin; Klein, Ronald; Klein, Barbara E.K; Tielsch, James M; Hubbard, Larry; Nieto, F.Javier

« Previous Next »Survey of Ophthalmology
Volume 46, Issue 1 , Pages 59-80, July 2001

Retinal Microvascular Abnormalities and their Relationship with Hypertension, Cardiovascular Disease, and Mortality

Tien Yin Wong, FRCS, MPH
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI, USA
- Singapore National Eye Center and Department of Ophthalmology, National University of Singapore, Singapore
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD, USA
- Reprint address: Tien Yin Wong, MD, MPH, Department of Ophthalmology and Visual Science, University of Wisconsin–Madison, 610 North Walnut Street, 460 WARF, Madison, WI 53705-2397.
Ronald Klein, MD, MPH
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI, USA
Barbara E.K Klein, MD, MPH
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI, USA
James M Tielsch, PhD
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins University School of Public Health, Baltimore, MD, USA
Larry Hubbard, MAT
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI, USA
F.Javier Nieto, MD, PhD
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD, USA

DONALD FONG AND JOHANNA SEDDON, EDITORS

Abstract

Retinal microvascular abnormalities, such as generalized and focal arteriolar narrowing, arteriovenous nicking and retinopathy, reflect cumulative vascular damage from hypertension, aging, and other processes. Epidemiological studies indicate that these abnormalities can be observed in 2–15% of the nondiabetic general population and are strongly and consistently associated with elevated blood pressure. Generalized arteriolar narrowing and arteriovenous nicking also appear to be irreversible long-term markers of hypertension, related not only to current but past blood pressure levels as well. There are data supporting an association between retinal microvascular abnormalities and stroke, but there is no convincing evidence of an independent or direct association with atherosclerosis, ischemic heart disease, or cardiovascular mortality. New computer-related imaging methods are currently being developed to detect the presence and severity of retinal arteriolar narrowing and other microvascular characteristics. When reliably quantified, retinal microvascular abnormalities may be useful as risk indicators for cerebrovascular diseases.

Keywords: arteriosclerosis, arteriovenous nicking, atherosclerosis, cardiovascular disease, hypertension, ischemic heart disease, retinal arteriolar narrowing, retinal arteriovenous ratio, retinal microvascular abnormalities, retinal photographic grading, retinopathy, stroke