Min, Evelyn Tai Li
(2016)
Evaluation of retinal vascular caliber in Malay children.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background:
Digital retinal vessel imaging is evolving as a non-invasive method of evaluating the
microvasculature. In children, the general absence of disease-related confounding
factors makes them an ideal study population. However, childhood studies in this
field are limited, especially among Malays, the main ethnicity in South East Asia.
The present study aims to evaluate the influence of ocular and systemic factors on
retinal vessel caliber in a childhood Malay population.
Methods:
This was a cross-sectional study involving 86 Malay children aged 6 to 12 years old
in Hospital Universiti Sains Malaysia, Malaysia. Ocular examination, refraction,
retinal photography and axial length were performed by standardized protocols.
Anthropometric measurements including blood pressure were likewise obtained.
Retinal vessel diameters were summarized as the central retinal arteriolar equivalent
(CRAE) and central retinal venular equivalent (CRVE) using validated computerbased
methods. Multiple linear regression was used to determine the effect of
systemic and ocular biometry on CRAE and CRVE.
Results:
After correcting for ocular magnification, the mean CRAE and CRVE were 171.40
um and 248.02 um respectively. Blood pressure (SBP, DBP, MAP) and axial length
were the main factors affecting the CRAE. After multivariable adjustment, each unit
(1 mm Hg) increase in mean arterial pressure was associated with a 0.451 um
reduction in CRAE (p=0.013). Each 1 mm increase in axial length was associated
with a 4.582 um narrowing of CRAE (p=0.024). All variables analyzed in our study
had no statistically significant effect on the CRVE.
Conclusion:
The mean retinal CRAE and CRVE in Malay children were 171.40 um and 248.02
um. Retinal arteriolar calibers are narrower in healthy children with higher blood
pressure and longer axial lengths. These associations suggest that the pathological
changes in the microvasculature seen hypertension and pathological myopia may be
an amplification of the normal physiological response of blood vessels to various
systemic and ocular dynamics.
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