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A Method for Peripapillary Retinal Vessel Tortuosity Measurement and Its Clinical Correspondence
Yuhang Zou1,2, Farzan Abdolahi1, Jeffrey A Gluckstein1
1Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Purpose:
Increased retinal vessel tortuosity is observed clinically and evaluated qualitatively in retinal diseases and intracranial hypertension. The purpose of the current study is to report a new method for quantitative measurement of peripapillary retinal vessel tortuosity (RVT) based on the first-order derivative of vessel centerlines.
Methods:
A total of 67 retinal vessels from images of three healthy (control) and three congenital venous tortuosity (pathology) eyes were evaluated. RVT was determined by vessel segmentation, centerline extraction, and first-order derivative calculation. The method was validated using sinusoidal functions with variable frequency and amplitude to simulate vessels. The reproducibility and performance of the method for detection of pathologies were established in human vessels. The association between clinical and RVT ranking of vessel tortuosity was determined. The relative ranking by clinical assessment was compared to the results by our method and curvature-based methods in selected vessels.
Results:
RVT values increased with both the frequency and amplitude of the simulated vessels. RVT measurements had a high interobserver reproducibility (intraclass correlation coefficient [ICC] = 0.92) and differentiated control and pathology vessels (P < 0.001). Clinical vessel tortuosity ranking was in excellent agreement with RVT ranking, similar to the agreement with ranking by curvature-based methods (ICC ≥ 0.88). Furthermore, measurements of RVT were more consistent with visual inspection than values obtained by curvature-based methods in selected simulated and human vessels.
Conclusions:
The application of this method has the potential to detect and monitor retinal vessel tortuosity changes due to ocular and systemic diseases.
Translational Relevance:
Quantitative and reproducible measurements of retinal vessel tortuosity that are consistent with clinical evaluation are needed for detection and monitoring of alterations due to ocular and systemic disorders to improve clinical care.
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