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Updated: Apr 16, 2026
Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies
Published on: October 22, 2014
Retinal microvasculature and cardiovascular health in childhood
Olta Gishti1, Vincent W V Jaddoe2, Janine F Felix3
1The Generation R Study Group, Department of Pediatrics, Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands;
Insights
Retinal vessel caliber in children is linked to cardiovascular health. Narrower arteries and wider veins correlate with higher blood pressure and hypertension risk, suggesting early microvascular changes impact future cardiovascular disease.
Area of Science:
- Ophthalmology
- Cardiology
- Pediatrics
Background:
- Retinal microvasculature alterations are linked to cardiovascular disease risk.
- Understanding these changes in children is crucial for early detection and prevention.
Purpose of the Study:
- To examine the associations between retinal vessel caliber and cardiovascular markers in school-age children.
- To investigate if microvascular adaptations in childhood predict future cardiovascular health.
Main Methods:
- Utilized digitized retinal photographs to measure retinal vessel calibers in 4007 school-age children.
- Measured various cardiovascular markers, including blood pressure and pulse wave velocity.
Main Results:
- Narrower retinal arterioles associated with higher blood pressure and hypertension risk.
- Wider retinal venules linked to lower blood pressure but higher carotid-femoral pulse wave velocity.
- Associations remained significant after adjusting for sociodemographic factors.
Conclusions:
- Retinal arteriolar and venular calibers are associated with blood pressure in children.
- Retinal venular caliber is also linked to arterial stiffness (carotid-femoral pulse wave velocity).
- Childhood microvascular adaptations may influence long-term cardiovascular health and disease risk.
Background And Objective:
Alterations in retinal microvasculature are associated with increased risk of cardiovascular disease. We examined the associations of retinal vessel caliber with cardiovascular markers in school-age children.
Methods:
Among 4007 school-age children (median age of 6.0 years), we measured cardiovascular markers and retinal vessel calibers from digitized retinal photographs.
Results:
Narrower retinal arteriolar caliber was associated with higher systolic and diastolic blood pressure (-0.20 SD score [SDS] [95% confidence interval (CI) -0.24 to -0.18] and -0.14 SDS [-0.17 to -0.11], respectively, per SDS increase in retinal arteriolar caliber), mean arterial pressure, and pulse pressure, but not with carotid-femoral pulse wave velocity, heart rate, cardiac output, or left ventricular mass. A wider retinal venular caliber was associated with lower systolic blood pressure, mean arterial pressure, and pulse pressure and higher carotid-femoral pulse wave velocity (carotid-femoral pulse wave velocity difference = 0.04 SDS [95% CI 0.01 to 0.07] per SDS increase in retinal venular caliber). Both narrower retinal arteriolar and venular calibers were associated with higher risk of hypertension at the age of 6 years, with the strongest association for retinal arteriolar caliber (odds ratio 1.35 [95% CI 1.21 to 1.45] per SDS decrease in arteriolar caliber). Adjustment for parental and infant sociodemographic factors did not influence the observed associations.
Conclusions:
Both retinal arteriolar and venular calibers are associated with blood pressure in school-age children, whereas retinal venular caliber is associated with carotid-femoral pulse wave velocity. Microvascular adaptations in childhood might influence cardiovascular health and disease from childhood onward.
