Microvascular vessels and microvascular remodeling play a major role in blood pressure (BP) regulation and peripheral tissue oxygen delivery. The adaptive optics camera (AOC), a novel technique of fundus image analysis enables the noninvasive characterization of microvascular remodeling in the retina on a large scale. Our objective was to assess the role of Blood Pressure (BP), ageing, diabetes and other risk factors on retinal arteriolar remodeling using AOC.

In 1.000 consecutive subjects in primary prevention with risk factors, we used the new RTX1^® AOC (Imagine-Eyes, Orsay, France) and a semi-automated segmentation software to measure Wall Thickness (WT), Internal Diameter (ID) and to calculate Wall-to-Lumen Ratio (WLR) and Wall Cross Sectional Area (WCSA) on retinal arteriolar microvasculature. BP was assessed on standard conditions using oscillometric device during the AOC assessment. Hypertension was defined as the presence of Systolic BP>140mmHg and/or Diastolic BP>90mmHg. Standardized clinical and biological examinations were performed to assess for the presence of diabetes, dyslipidemia, obesity and current smoking which were defined according to guidelines.

Overall, ageing was associated with an increase in WLR due to sole WT increase. Subjects with office hypertension (n=313) had inward eutrophic remodeling with increased WLR (0.325±0.049 vs 0.292±0.056) due to higher WT, lower ID and overall stable WCSA. Diabetics (n=180) presented with hypertrophic remodeling indicated by higher WLR due to a significant increase in WT and WCSA concomitant to a normal BP. There was no significant remodeling associated with other cardiovascular risk factors. In multivariate analysis, BP and age remained independent positive correlates of WLR and WT whereas age had no influence on ID and only BP negatively correlated to ID
Abstract CO-01 – TableNRetinal Arteriolar MicrovasculatureBlood PressureWLRID.-μmWT.-μmWCSA.-μm2Systolic BP.-MmHgDiastolic BP.-MmHgGenderFemale4890.301±.0.5079.0±10.923.5±3.63386±817*129.5±21.272.2±13.7Male5110.300±.0.5777.3±11.122.89±4.23234±886132.2±19.471.5±13.8HypertensionYes3130.325±.0.49‡75.6±10.9†24.2±4.0‡3392±832153.1±16.1‡82.1±14.8‡No6870.292±.0.5678.6±10.822.7±3.63249±873120.8±12.467.1±10.3DiabetesYes1800.308±.0.5279.5±11.224.2±3.8‡3523±861†134.4±19.670.8±13.6No8200.299±.0.5577.8±11.223.0±3.93256±844130.2±20.572.1±13.9DyslipidemiaYes4360.301±.0.5777.6±11.123.3±4.13333±828130.4±20.069.4±12.2‡No5640.301±.0.5378.6±11.123.2±3.73281±886131.3±20.673.7±14.6ObesityYes1640.303±.0.5577.0±11.423.2±3.93255±838136.1±20.3‡76.3±13.2‡No8360.300±.0.5578.2±10.823.1±3.93307±838129.3±20.370.5±13.7WLR is Wall-to-Lumen Ratio, ID is internal Diameter, WT is Wall Thickness, WCSA is Wall Cross Sectionnal Area, BP is blood pressure*p<.01†p<001‡p<.0001 between groups

Hypertension, age and diabetes are associated with increase in WLR and WT. Assessment OF WT and ID are mandatory to perform a correct interpretation of WLR increase. OAC could represent a promising tool for interventional studies on treatment-induced remodeling regression.