Dataset Information

Retinal vessel caliber among people with acquired immunodeficiency syndrome: relationships with visual function.

ABSTRACT:

Purpose

To evaluate relationships between retinal vessel caliber and tests of visual function among people with AIDS.

Design

Longitudinal, observational cohort study.

Methods

We evaluated data for participants without ocular opportunistic infections at initial examination (baseline) in the Longitudinal Studies of the Ocular Complications of AIDS (1998-2008). Visual function was evaluated with best-corrected visual acuity, Goldmann perimetry, automated perimetry (Humphrey Field Analyzer), and contrast sensitivity (CS) testing. Semi-automated grading of fundus photographs (1 eye/participant) determined central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) at baseline. Multiple linear regression models, using forward selection, sought independent relationships between indices and visual function variables.

Results

Included were 1250 participants. Smaller AVR was associated with reduced visual field by Goldmann perimetry (P = .003) and worse mean deviation (P = .02) on automated perimetry and possibly with worse pattern standard deviation (PSD) on automated perimetry (P = .06). There was a weak association between smaller AVR and worse CS (P = .07). Relationships were independent of antiretroviral therapy and level of immunodeficiency (CD4+ T lymphocyte count, human immunodeficiency virus [HIV] RNA blood level). On longitudinal analysis, retinal vascular indices at baseline did not predict changes in visual function.

Conclusions

Variation in retinal vascular indices is associated with abnormal visual function in people with AIDS, manifested by visual field loss and possibly by reduced CS. Relationships are consistent with the hypothesis that HIV-related retinal vasculopathy is a contributing factor to vision dysfunction among HIV-infected individuals. Longitudinal studies are needed to determine whether changes in indices predict change in visual function.

SUBMITTER: Kalyani PS

PROVIDER: S-EPMC4859428 | biostudies-literature | 2012 Mar

REPOSITORIES: biostudies-literature

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Publications

Retinal vessel caliber among people with acquired immunodeficiency syndrome: relationships with visual function.

Kalyani Partho S PS Fawzi Amani A AA Gangaputra Sapna S van Natta Mark L ML Hubbard Larry D LD Danis Ronald P RP Thorne Jennifer E JE Holland Gary N GN

American journal of ophthalmology 20111022 3

<h4>Purpose</h4>To evaluate relationships between retinal vessel caliber and tests of visual function among people with AIDS.<h4>Design</h4>Longitudinal, observational cohort study.<h4>Methods</h4>We evaluated data for participants without ocular opportunistic infections at initial examination (baseline) in the Longitudinal Studies of the Ocular Complications of AIDS (1998-2008). Visual function was evaluated with best-corrected visual acuity, Goldmann perimetry, automated perimetry (Humphrey Fi ...[more]

PMID: 22019221

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Project description:Retinal vessel calibers share anatomic and physiologic characteristics with the cerebral vasculature and can be visualized noninvasively. In light of the known microvascular contributions to brain health and cognitive function, we aimed to determine if, in a community based-study, retinal vessel calibers and change in caliber over 8 years are associated with cognitive function or trajectory. Participants in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort who completed cognitive testing at Exam 5 (2010-2012) and had retinal vascular caliber measurements (Central Retinal Artery and Vein Equivalents; CRAE and CRVE) at Exam 2 (2002-2004) and Exam 5 were included. Using multivariable linear regression, we evaluated the association of CRAE and CRVE from Exam 2 and Exam 5 and their change between the two exams with scores on tests of global cognitive function (Cognitive Abilities Screening Instrument; CASI), processing speed (Digit Symbol Coding; DSC) and working memory (Digit Span; DS) at Exam 5 and with subsequent change in cognitive scores between Exam 5 and Exam 6 (2016-2018).The main effects are reported as the difference in cognitive test score per SD increment in retinal vascular caliber with 95% confidence intervals (CI). A total of 4334 participants (aged 61.6 ± 9.2 years; 53% female; 41% White) completed cognitive testing and at least one retinal assessment. On multivariable analysis, a 1 SD larger CRAE at exam 5 was associated with a lower concomitant CASI score (- 0.24, 95% CI - 0.46, - 0.02). A 1 SD larger CRVE at exam 2 was associated with a lower subsequent CASI score (- 0.23, 95%CI - 0.45, - 0.01). A 1 SD larger CRVE at exam 2 or 5 was associated with a lower DSC score [(- 0.56, 95% CI - 1.02, - 0.09) and - 0.55 (95% CI - 1.03, - 0.07) respectively]. The magnitude of the associations was relatively small (2.8-3.1% of SD). No significant associations were found between retinal vessel calibers at Exam 2 and 5 with the subsequent score trajectory of cognitive tests performance over an average of 6 years. Wider retinal venular caliber was associated with concomitant and future measures of slower processing speed but not with later cognitive trajectory. Future studies should evaluate the utility of these measures in risk stratification models from a clinical perspective as well as for screening on a population level.

Project description:BackgroundChanges in the retinal vessel caliber are associated with a variety of major diseases, namely diabetes, hypertension and atherosclerosis. The clinical assessment of these changes in fundus images is tiresome and prone to errors and thus automatic methods are desirable for objective and precise caliber measurement. However, the variability of blood vessel appearance, image quality and resolution make the development of these tools a non-trivial task.MetholodogyA method for the estimation of vessel caliber in eye fundus images via vessel cross-sectional intensity profile model fitting is herein proposed. First, the vessel centerlines are determined and individual segments are extracted and smoothed by spline approximation. Then, the corresponding cross-sectional intensity profiles are determined, post-processed and ultimately fitted by newly proposed parametric models. These models are based on Difference-of-Gaussians (DoG) curves modified through a multiplying line with varying inclination. With this, the proposed models can describe profile asymmetry, allowing a good adjustment to the most difficult profiles, namely those showing central light reflex. Finally, the parameters of the best-fit model are used to determine the vessel width using ensembles of bagged regression trees with random feature selection.Results and conclusionsThe performance of our approach is evaluated on the REVIEW public dataset by comparing the vessel cross-sectional profile fitting of the proposed modified DoG models with 7 and 8 parameters against a Hermite model with 6 parameters. Results on different goodness of fitness metrics indicate that our models are constantly better at fitting the vessel profiles. Furthermore, our width measurement algorithm achieves a precision close to the observers, outperforming state-of-the art methods, and retrieving the highest precision when evaluated using cross-validation. This high performance supports the robustness of the algorithm and validates its use in retinal vessel width measurement and possible integration in a system for retinal vasculature assessment.

Dataset Information

Retinal vessel caliber among people with acquired immunodeficiency syndrome: relationships with visual function.

Purpose

Design

Methods

Results

Conclusions

Publications

Retinal vessel caliber among people with acquired immunodeficiency syndrome: relationships with visual function.

Similar Datasets

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