Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. kamran_ikram @ nuhs.edu.sg
Ophthalmologica. 2013;229(3):125-36. doi: 10.1159/000342158. Epub 2012 Sep 20.
The retinal vasculature provides a unique window to assess vascular health noninvasively and directly in vivo. Advances in fundus photography and retinal image analysis techniques have enabled the objective and accurate assessment of quantitative retinal vascular caliber measurement. Over the last decade, large population-based studies have shown that retinal vascular calibers are associated with a wide range of subclinical (e.g. atherosclerosis, inflammation and endothelial dysfunction) and clinical cardiovascular diseases (hypertension, diabetes mellitus, stroke, kidney and heart diseases). However, while retinal image analysis provided exciting possibilities to study the pathogenesis of these diseases, its direct applicability in a clinical setting as a 'test' to predict cardiovascular diseases is yet to be established, particularly within the context of being used as a population screening tool. Nevertheless, with continual development of retinal imaging techniques and newer understanding of the clinical significance of these retinal changes, there remains scope for the development of retinal vascular caliber measurements as a biomarker for vascular disease risk assessment in targeted areas and patient subgroups (e.g. patients with diabetes, suspected hypertension and stroke).
视网膜血管系统为评估血管健康提供了一个独特的无创、直接的活体窗口。眼底摄影和视网膜图像分析技术的进步使得定量视网膜血管口径测量的客观、准确评估成为可能。在过去的十年中，大量基于人群的研究表明，视网膜血管口径与广泛的亚临床疾病（如动脉粥样硬化、炎症和内皮功能障碍）和临床心血管疾病（高血压、糖尿病、中风、肾病和心脏病）有关。然而，虽然视网膜图像分析为研究这些疾病的发病机制提供了令人兴奋的可能性，但它作为一种“测试”来预测心血管疾病的直接适用性，尤其是作为一种人群筛查工具，尚未得到证实。尽管如此，随着视网膜成像技术的不断发展和对这些视网膜变化的临床意义的进一步了解，视网膜血管口径测量仍有可能作为血管疾病风险评估的生物标志物，在特定领域和患者亚组（如糖尿病患者、疑似高血压和中风患者）中得到发展。
