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Increased retinal venular calibre in acute infections
Cara Fitt1, Thao Vi Luong1, Damian Cresp2
1Department of Medicine, Melbourne Health and Northern Health, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, 3050, Australia.
Scientific Reports
|August 27, 2021
Summary
Severe infections in hospitalized patients cause temporary widening of retinal venules (CRVE). This venular widening resolves with antibiotic treatment and decreasing C-reactive protein (CRP) levels, highlighting potential confounders in retinal vascular assessments.
Area of Science:
- Ophthalmology
- Cardiology
- Infectious Diseases
Background:
- Increased retinal venular calibre is a known risk factor for cardiac disease, stroke, and other cardiovascular events.
- Venular dilatation is associated with chronic inflammatory conditions such as diabetes, obesity, dyslipidemia, and autoimmune diseases.
- The impact of acute inflammation from infections on microvascular calibre, specifically retinal venular calibre, requires further investigation.
Purpose of the Study:
- To investigate whether inflammation associated with acute infections affects microvascular calibre, particularly retinal venular calibre (CRVE).
- To assess changes in CRVE and arteriolar calibre (CRAE) in hospitalized patients with severe infections before and after antibiotic treatment.
- To determine if changes in inflammatory markers, such as C-reactive protein (CRP), correlate with alterations in retinal microvascular calibre.
Main Methods:
- Recruitment of 41 hospitalized patients with severe infections (CRP > 100 mg/L) and 13 additional participants with persistent high CRP.
- Collection of demographic and vascular risk factor data, followed by non-mydriatic retinal photography.
- Measurement of retinal arteriole and venule calibre using validated semi-automated software (IVAN) before and after antibiotic treatment, correlating with CRP and neutrophil count changes.
Main Results:
- Following antibiotic treatment, mean CRP levels significantly decreased (172.9 to 42.2 mg/L, p < 0.0001) and mean neutrophil counts fell (p < 0.0001).
- A statistically significant decrease in mean venular calibre (CRVE) was observed (240.9 to 233.4 MU, p = 0.0017), while arteriolar calibre (CRAE) remained unchanged (p = 0.84).
- Participants with persistent high CRP levels showed no significant changes in CRAE or CRVE before and after treatment (p > 0.05).
Conclusions:
- Acute, severe infections in hospitalized patients lead to a temporary increase in retinal venular calibre (CRVE).
- This venular dilatation resolves with effective antibiotic treatment and reduction in systemic inflammation (indicated by falling CRP levels).
- Transient changes in CRVE during infections may confound retinal vascular assessments related to blood pressure control and cardiovascular risk prediction.
