Longitudinal association between psychosocial stress and retinal microvasculature in children and adolescents

Retinal microvessels provides a window to assess the microcirculation of heart and brain, and might reflect cardio- or cerebrovascular disease risk. Limited information exist on the relation between psychosocial stress and the microcirculation, even though psychosocial stress might trigger vascular diseases. This study investigates whether childhood psychosocial stress is a predictor of retinal microvasculature.

We followed-up 182 Belgian children, aged 5.7-11.3 years at baseline (53.3% boys). Information about psychosocial stress was obtained using emotional, behavioral and negative life events questionnaires and hair cortisol, an objective stress marker. Retinal photographs were used to calculate vessel diameters, bifurcation angles and optimality deviation with semiautomated software. Cross-sectional and longitudinal associations were explored using multivariable regression analysis with retinal parameters in 2015 as outcome, while adjusting for age, sex, socioeconomic status, cardiovascular parameters and lifestyle factors.

Feelings of happiness, sadness and negative life events were associated with retinal vascular diameter, but behavior and hair cortisol were not. High stress levels over a 4-year time period (less happy, sadder and higher total negative emotions) were associated with larger venules (β = 0.21-0.43) and children who experienced more negative life events had smaller arterioles (β = -0.15). No consistent patterns were seen with bifurcation angles and optimality deviation.

Based on the results, we conclude that high levels of childhood psychosocial stress unfavorably affect the retinal vascular diameters, potentially reflecting the microvasculature of the heart and brain. It seems this might even be independent of lifestyle and BMI, but further research on mechanisms is necessary.