Hypertension and ageing have been associated with retinal arteriolar narrowing but precise evaluation of remodeling determinants has not been investigated.
Our objectives were to assess the effect of age on retinal arteriolar remodeling in elderly treated and controlled hypertensives with and without mild cognitive injuries using Adaptive optics camera (AOC) and a control group of hypertensives patients.
Design and method:
We used the AOC rtx1™ (Imagine-Eyes, Orsay, France) to measure wall thickness, internal diameter and to calculate Wall-to-Lumen Ratio (WLR) and Wall Cross Sectional Area (WCSA) of retinal arterioles in 47 non diabetics treated hypertensives over 65years with or without mild cognitive injuries assessed by MMS and in 47 younger with an age <60 treated hypertensives matched for gender, systolic, diastolic and pulse pressure as well as cardiovascular risk factors.
Systolic BP did not differ between the 2 groups 131.7 ± 147.0 vs.131.4.4 ± 19.0 mmHg but diastolic BP was higher in the control group (73.0 ± 9.1 vs.66.8.0 ± 10.2 mmHg). While age was significantly higher in the elderly group (75.8 ± 4.9 vs.51.5 ± 5.8 years, p < .00001), WLR did not differ between the 2 populations (0.297 ± 0.049 vs.0.295 ± 0.056). However, larger lumen (832.2 ± 9.4 vs. 77.2 ± 11.6 μm, p = .008), higher parietal thickness (24.3 ± 4.0 vs. 22.7 ± 3.9 μm, p = .04) and greater WCSA (3642 ± 813 vs.3217 ± 877 μm2, p = .02) were observer in older hypertensives. No correlation were found between retinal arteriolar indices and age, blood pressures levels or MMS in the older population whereas in the whole populationage strongly correlated with all retinal arteriolar parameters.
AOC high resolution and reproducibility enables to observe for the first in time in very elderly hypertensives a proportional augmentation of lumen, thickness and wall cross sectional area without WLR elevation.