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Body mass index, blood pressure, and physical activity all affect retinal vessel diameters, authors of the meta-analysis found.
The findings raise the possibility that, one day, clinicians could help “substantially counteract” the increasing burden of adult cardiovascular disease by diagnosing retinal microvascular impairments early in life, according to investigator Sabrina Köchli, MSc, and her colleagues with the department of sport, exercise, and health at the University of Basel (Switzerland).
“Regular retinal vessel screening may have the potential to be implemented in future medical examination programs to optimize therapy guidance in children and adolescents,” Ms. Köchli and her colleagues wrote in the journal Pediatrics.
The meta-analysis by Ms. Köchli and her coauthors included 11 studies looking at the association between BMI, blood pressure, or physical activity in children.
They found that higher BMI was associated with narrower retinal arteriolar diameters and wider venular diameters in 8 studies including a total of 5,003 participants. The pooled estimate effect size was –0.37 for the association between BMI and retinal arteriolar diameters and 0.35 for the association between BMI and retinal venular diameters, data showed.
Higher blood pressure likewise was associated with narrower retinal arteriolar diameters in 6 studies including 7,687 participants, with a pooled estimate of –0.63 for systolic blood pressure and –0.60 for diastolic blood pressure.
Several studies individually showed that physical activity was associated with retinal vessel diameters. For example, one German study of school children showing that physical inactivity was associated with a lower arteriolar-to-venular diameter. And an Australian study found that more time spent outdoors engaged in physical activity was tied to wider arteriolor diameters and that sedentary behavior was linked to narrower arteriolor diameters. However, because of differences among the studies in how physical activity or inactivity was measured, meta-analysis was not possible, the investigators said.
Retinal vessels, part of the cerebrovascular bed, have been described as a “window to the heart,” Ms. Köchli and her coauthors said in their report. Previous investigations have recently shown that retinal vessel diameters may predict cardiovascular outcomes in adults over the long term.
That suggests retinal vessel diameters are a “reproducible biomarker” that adds value in determining atherosclerotic cardiovascular disease risk, the authors commented.
“However, future researchers will have to ensure that retinal vessel imaging during childhood development has a prognostic value for the adult clinical outcome of pediatric populations,” they added.
No external funding was received for the study. Ms. Köchli and her coauthors had no financial disclosures or potential conflicts of interest to disclose.
SOURCE: Köchli S et al. Pediatrics. 2018;141(6):e20174090
Currently, retinal vessel diameters are not a strong contender for clinical risk prediction, Alan E. Simon, MD, and Matthew W. Gillman, MD, wrote in an editorial commenting on the study by Köchli et al.
However, the concept has “intuitive appeal because the eye provides the opportunity to view systemic arteries and veins directly,” wrote Dr. Simon and Dr. Gillman.
The association between childhood retinal vessel diameters and cardiovascular endpoints in adults has not been evaluated, understandably, because of the very long follow-up that would be required. And even though studies have suggested that there might be some small added benefit for women in adding adult retinal vessel diameters to other cardiovascular risk prediction scores, the same does not appear to be true for men.
Even if childhood retinal vessel diameters had strong predictive value, it’s still not clear whether the retinal vessel evaluation would be useful for pediatricians grouping patients into risk categories for strokes or heart attacks at some point in the future.
Likewise, using retinal vessel diameters as an outcome measure in clinical trials is not justified at present, although that could change in the future.
“As technological advances make this novel assessment more available to clinicians, we hope that such availability is accompanied by additional evidence for or against its usefulness among clinicians and researchers,” the authors said in the editorial.
Currently, retinal vessel diameters are not a strong contender for clinical risk prediction, Alan E. Simon, MD, and Matthew W. Gillman, MD, wrote in an editorial commenting on the study by Köchli et al.
However, the concept has “intuitive appeal because the eye provides the opportunity to view systemic arteries and veins directly,” wrote Dr. Simon and Dr. Gillman.
The association between childhood retinal vessel diameters and cardiovascular endpoints in adults has not been evaluated, understandably, because of the very long follow-up that would be required. And even though studies have suggested that there might be some small added benefit for women in adding adult retinal vessel diameters to other cardiovascular risk prediction scores, the same does not appear to be true for men.
Even if childhood retinal vessel diameters had strong predictive value, it’s still not clear whether the retinal vessel evaluation would be useful for pediatricians grouping patients into risk categories for strokes or heart attacks at some point in the future.
Likewise, using retinal vessel diameters as an outcome measure in clinical trials is not justified at present, although that could change in the future.
“As technological advances make this novel assessment more available to clinicians, we hope that such availability is accompanied by additional evidence for or against its usefulness among clinicians and researchers,” the authors said in the editorial.
Currently, retinal vessel diameters are not a strong contender for clinical risk prediction, Alan E. Simon, MD, and Matthew W. Gillman, MD, wrote in an editorial commenting on the study by Köchli et al.
However, the concept has “intuitive appeal because the eye provides the opportunity to view systemic arteries and veins directly,” wrote Dr. Simon and Dr. Gillman.
The association between childhood retinal vessel diameters and cardiovascular endpoints in adults has not been evaluated, understandably, because of the very long follow-up that would be required. And even though studies have suggested that there might be some small added benefit for women in adding adult retinal vessel diameters to other cardiovascular risk prediction scores, the same does not appear to be true for men.
Even if childhood retinal vessel diameters had strong predictive value, it’s still not clear whether the retinal vessel evaluation would be useful for pediatricians grouping patients into risk categories for strokes or heart attacks at some point in the future.
Likewise, using retinal vessel diameters as an outcome measure in clinical trials is not justified at present, although that could change in the future.
“As technological advances make this novel assessment more available to clinicians, we hope that such availability is accompanied by additional evidence for or against its usefulness among clinicians and researchers,” the authors said in the editorial.
Body mass index, blood pressure, and physical activity all affect retinal vessel diameters, authors of the meta-analysis found.
The findings raise the possibility that, one day, clinicians could help “substantially counteract” the increasing burden of adult cardiovascular disease by diagnosing retinal microvascular impairments early in life, according to investigator Sabrina Köchli, MSc, and her colleagues with the department of sport, exercise, and health at the University of Basel (Switzerland).
“Regular retinal vessel screening may have the potential to be implemented in future medical examination programs to optimize therapy guidance in children and adolescents,” Ms. Köchli and her colleagues wrote in the journal Pediatrics.
The meta-analysis by Ms. Köchli and her coauthors included 11 studies looking at the association between BMI, blood pressure, or physical activity in children.
They found that higher BMI was associated with narrower retinal arteriolar diameters and wider venular diameters in 8 studies including a total of 5,003 participants. The pooled estimate effect size was –0.37 for the association between BMI and retinal arteriolar diameters and 0.35 for the association between BMI and retinal venular diameters, data showed.
Higher blood pressure likewise was associated with narrower retinal arteriolar diameters in 6 studies including 7,687 participants, with a pooled estimate of –0.63 for systolic blood pressure and –0.60 for diastolic blood pressure.
Several studies individually showed that physical activity was associated with retinal vessel diameters. For example, one German study of school children showing that physical inactivity was associated with a lower arteriolar-to-venular diameter. And an Australian study found that more time spent outdoors engaged in physical activity was tied to wider arteriolor diameters and that sedentary behavior was linked to narrower arteriolor diameters. However, because of differences among the studies in how physical activity or inactivity was measured, meta-analysis was not possible, the investigators said.
Retinal vessels, part of the cerebrovascular bed, have been described as a “window to the heart,” Ms. Köchli and her coauthors said in their report. Previous investigations have recently shown that retinal vessel diameters may predict cardiovascular outcomes in adults over the long term.
That suggests retinal vessel diameters are a “reproducible biomarker” that adds value in determining atherosclerotic cardiovascular disease risk, the authors commented.
“However, future researchers will have to ensure that retinal vessel imaging during childhood development has a prognostic value for the adult clinical outcome of pediatric populations,” they added.
No external funding was received for the study. Ms. Köchli and her coauthors had no financial disclosures or potential conflicts of interest to disclose.
SOURCE: Köchli S et al. Pediatrics. 2018;141(6):e20174090
Body mass index, blood pressure, and physical activity all affect retinal vessel diameters, authors of the meta-analysis found.
The findings raise the possibility that, one day, clinicians could help “substantially counteract” the increasing burden of adult cardiovascular disease by diagnosing retinal microvascular impairments early in life, according to investigator Sabrina Köchli, MSc, and her colleagues with the department of sport, exercise, and health at the University of Basel (Switzerland).
“Regular retinal vessel screening may have the potential to be implemented in future medical examination programs to optimize therapy guidance in children and adolescents,” Ms. Köchli and her colleagues wrote in the journal Pediatrics.
The meta-analysis by Ms. Köchli and her coauthors included 11 studies looking at the association between BMI, blood pressure, or physical activity in children.
They found that higher BMI was associated with narrower retinal arteriolar diameters and wider venular diameters in 8 studies including a total of 5,003 participants. The pooled estimate effect size was –0.37 for the association between BMI and retinal arteriolar diameters and 0.35 for the association between BMI and retinal venular diameters, data showed.
Higher blood pressure likewise was associated with narrower retinal arteriolar diameters in 6 studies including 7,687 participants, with a pooled estimate of –0.63 for systolic blood pressure and –0.60 for diastolic blood pressure.
Several studies individually showed that physical activity was associated with retinal vessel diameters. For example, one German study of school children showing that physical inactivity was associated with a lower arteriolar-to-venular diameter. And an Australian study found that more time spent outdoors engaged in physical activity was tied to wider arteriolor diameters and that sedentary behavior was linked to narrower arteriolor diameters. However, because of differences among the studies in how physical activity or inactivity was measured, meta-analysis was not possible, the investigators said.
Retinal vessels, part of the cerebrovascular bed, have been described as a “window to the heart,” Ms. Köchli and her coauthors said in their report. Previous investigations have recently shown that retinal vessel diameters may predict cardiovascular outcomes in adults over the long term.
That suggests retinal vessel diameters are a “reproducible biomarker” that adds value in determining atherosclerotic cardiovascular disease risk, the authors commented.
“However, future researchers will have to ensure that retinal vessel imaging during childhood development has a prognostic value for the adult clinical outcome of pediatric populations,” they added.
No external funding was received for the study. Ms. Köchli and her coauthors had no financial disclosures or potential conflicts of interest to disclose.
SOURCE: Köchli S et al. Pediatrics. 2018;141(6):e20174090
Key clinical point: In children, retinal vessel diameters may be sensitive biomarkers for cardiovascular risk stratification.
Major finding: BMI was associated with retinal arteriolar and venular diameters; blood pressure also was associated with retinal arteriolar diameters.
Study details: A meta-analysis of 11 studies.
Disclosures: No external funding was received for the study. Authors reported that they had no financial disclosures or potential conflicts of interest.
Source: Köchli S et al. Pediatrics. 2018;141(6):e20174090.