Lim Beth Shi Yu, Li Ling-Jun
Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
Matern Fetal Med. 2024 Apr 4;6(2):92-96. doi: 10.1097/FM9.0000000000000222. eCollection 2024 Apr.
Over the past two decades, population-based studies employing semiautomatic computer-assisted programs have uncovered associations between retinal microvascular features and various systemic conditions. As the recognition of retinal imaging in cardiometabolic health grows, there is increasing evidence supporting its application in women's health, particularly during the reproductive age. This review aims to summarize the indications of retinal imaging in women's health and intergenerational health, where suboptimal retinal imaging has been found to mirror pathological systemic changes, such as suboptimal hemodynamic circulation, inflammation, endothelial dysfunction, oxidative stress, and hypoxia . Findings from Singapore Growing Up in Singapore Towards Healthy Outcomes and Singapore Preconception Study of Long-Term Maternal and Child Outcomes cohorts have reported serial changes in retinal conventional microvascular features (e.g., retinal arteriolar narrowing, retinal venular widening) and retinal geometric microvascular features (e.g., sparse fractal dimension, enlarged branching angle, and increased curvature tortuosity) during the preconception and antenatal phases. These morphological abnormalities were found to be related to female fertility, maternal antenatal health conditions, postnatal maternal cardiometabolic health, and intergenerational health in the fetus. Given the compelling evidence of the ability to detect microvascular changes through noninvasive methods at an early stage, retinal imaging holds the potential to facilitate timely interventions, mitigate the progression of complications, and prevent adverse pregnancy outcomes. Looking ahead, the convergence of artificial intelligence and advanced imaging techniques heralds a promising era in women's health research and clinical practice.
在过去二十年中，采用半自动计算机辅助程序的基于人群的研究发现了视网膜微血管特征与各种全身状况之间的关联。随着视网膜成像在心脏代谢健康方面的认可度不断提高，越来越多的证据支持将其应用于女性健康领域，尤其是在育龄期。本综述旨在总结视网膜成像在女性健康和代际健康中的应用指征，在这些领域中，视网膜成像欠佳已被发现反映了病理系统性变化，如血流动力学循环欠佳、炎症、内皮功能障碍、氧化应激和缺氧。来自新加坡“在新加坡成长迈向健康成果”研究以及新加坡长期母婴结局孕前研究队列的结果报告了孕前和产前阶段视网膜传统微血管特征（如视网膜小动脉变窄、视网膜小静脉增宽）和视网膜几何微血管特征（如稀疏分形维数、分支角增大和曲率扭曲增加）的系列变化。这些形态学异常被发现与女性生育能力、孕产妇产前健康状况、产后孕产妇心脏代谢健康以及胎儿的代际健康有关。鉴于有令人信服的证据表明能够通过非侵入性方法在早期检测到微血管变化，视网膜成像有可能促进及时干预、减轻并发症进展并预防不良妊娠结局。展望未来，人工智能与先进成像技术的融合预示着女性健康研究和临床实践的一个充满希望的时代。
