Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit of Salamanca (APISAL). Health Service of Castilla y León (SACyL), Salamanca, Spain.
BISITE Research Group, Computers and Automation Department, University of Salamanca (USAL), Salamanca Institute for Biomedical Research (IBSAL), Salamanca, Spain.
Int J Med Inform. 2020 Apr;136:104090. doi: 10.1016/j.ijmedinf.2020.104090. Epub 2020 Feb 3.
The examination of the fundus allows to evaluate retinal the microcirculation in vivo. We assess the reliability and validity of ALTAIR software, and to evaluate its clinical relevance by the association of thickness, area and length of the retinal vessels with other measures of vascular structure and function, target organ damage and cardiovascular risk.
Cross-sectional study involving a total of 250 subjects aged 62 ± 9 years, 51 % males. In a random subsample of 60 subjects (118 retinographies), we estimated the intraobserver, interobserver and interdevice intraclass correlation coefficients (ICC) of the measurements of retinal vascular thickness, area and length in 3 concentric circles. Concurrent validity was assessed with all 250 subjects (495 retinographies), analysing the relationship to age, blood pressure, target organ damage, vascular structure and function, and cardiovascular risk.
Of the sample, 69 % were diagnosed with hypertension and 17 % with diabetes. Intraobserver ICC ranged from 0.640 for venous length to 0.906 for arterial area. Interobserver ICC ranged from 0.809 for arterial length to 0.916 for venous area, and interdevice ICC for arteriovenous ratio (AVR) was 0.887, thickness of arteries 0.590 and vein thickness 0.677. We found a moderate correlation between retinal vascular parameters and vascular structure and function, and target organ damage. In multiple linear regression analysis, the association with blood pressure, albumin/creatinine ratio, carotid intima-media thickness and cardiovascular risk is maintained.
The ALTAIR tool has been useful for analysing the thickness, area and length of retinal vessels, with adequate reliability and a concomitant association of retinal vessel measurements with other cardiovascular parameters and cardiovascular risk. Therefore, in addition to thickness, the area and length of retinal vessels could also play a role in the prediction of cardiovascular risk.
眼底检查可评估视网膜的微循环。我们评估了 ALTAIR 软件的可靠性和有效性，并通过视网膜血管的厚度、面积和长度与其他血管结构和功能、靶器官损伤以及心血管风险的测量值之间的关联来评估其临床相关性。
这项横断面研究共纳入了 250 名年龄为 62±9 岁的受试者，其中 51%为男性。在 60 名受试者的随机亚样本（118 张眼底照片）中，我们评估了视网膜血管厚度、面积和长度在 3 个同心圈内的测量值的观察者内、观察者间和设备间的组内相关系数（ICC）。我们对所有 250 名受试者（495 张眼底照片）进行了一致性评估，分析了与年龄、血压、靶器官损伤、血管结构和功能以及心血管风险的关系。
在该样本中，69%被诊断为高血压，17%患有糖尿病。观察者内 ICC 范围从静脉长度的 0.640 到动脉面积的 0.906。观察者间 ICC 范围从动脉长度的 0.809 到静脉面积的 0.916，动静脉比（AVR）的设备间 ICC 为 0.887，动脉厚度的 ICC 为 0.590，静脉厚度的 ICC 为 0.677。我们发现视网膜血管参数与血管结构和功能以及靶器官损伤之间存在中度相关性。在多元线性回归分析中，与血压、白蛋白/肌酐比、颈动脉内膜中层厚度和心血管风险的相关性仍然存在。
ALTAIR 工具可用于分析视网膜血管的厚度、面积和长度，具有足够的可靠性，并且视网膜血管测量值与其他心血管参数和心血管风险具有伴随相关性。因此，除了厚度之外，视网膜血管的面积和长度也可能在心血管风险预测中发挥作用。
Zotero 插件