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Primary health prevention in at-risk children is receiving increased attention while less information is available on cardiovascular profile and response to exercise in healthy children. Our study examined the effects of a gross motor skill-based exercise intervention on micro- and macro-vascular health in preschoolers. This is a sub-study of a five-armed clinical trial with six kindergartens and 68 children. Four kindergartens were assigned to the intervention group (INT) and two to control groups (CON). We performed gross motor skill assessment (TGMD-2), static retinal vessel analysis, and measurements of central hemodynamics before and after the intervention. INT received one weekly exercise session for 25 weeks, while CON received no intervention. We calculated linear regressions correcting for age, sex, BMI-percentile, and baseline. We observed favorable effects in TGMD-2 for INT over CON (Cohen's d = 0.52 95% CI [0.15; 0.90]). Trivial between-group differences were observed in retinal vessel diameters (0.08 < d ≤ 0.29) and trivial to moderate differences in all other arterial stiffness parameters (−0.55 < d ≤ 0.31). Motor-skill based interventions are sensible measures to incorporate physical activity in pre-schools and improve gross motor proficiency at a very young age. The potential of motor skill-based interventions as primordial prevention strategy in healthy preschoolers needs to be further investigated. [ABSTRACT FROM AUTHOR]

The healthcare burden of cardiovascular diseases remains a major issue worldwide. Understanding the underlying mechanisms and improving identification of people with a higher risk profile of systemic vascular disease through noninvasive examinations is crucial. In ophthalmology, retinal vascular network imaging is simple and noninvasive and can provide in vivo information of the microstructure and vascular health. For more than 10 years, different research teams have been working on developing software to enable automatic analysis of the retinal vascular network from different imaging techniques (retinal fundus photographs, OCT angiography, adaptive optics, etc.) and to provide a description of the geometric characteristics of its arterial and venous components. Thus, the structure of retinal vessels could be considered a witness of the systemic vascular status. A new approach called "oculomics" using retinal image datasets and artificial intelligence algorithms recently increased the interest in retinal microvascular biomarkers. Despite the large volume of associated research, the role of retinal biomarkers in the screening, monitoring, or prediction of systemic vascular disease remains uncertain. A PubMed search was conducted until August 2022 and yielded relevant peer-reviewed articles based on a set of inclusion criteria. This literature review is intended to summarize the state of the art in oculomics and cardiovascular disease research. [ABSTRACT FROM AUTHOR]

Atherosclerosis is a common cause of cardiac attack and its early detection prevents further complications. In this paper, a research concept is proposed focusing on a novel method of classification system. This method is carried out with image features derived from fundus photographs. It depends upon the arteries and vein classification process and also by the morphological appearance. Further, the proposed mixed algorithm, by using the retina fundal images, this method achieves an accuracy of detecting Atherosclerosis. In spite of the method being somewhat a hard one, of late, several methods are developed which employ advanced retinal photographic imaging techniques. These techniques involve characterizing, measuring and quantifying any variations and dissimilarities in the retinal structure. The hallmark of these methods, which have both qualitative and quantitative prediction, illustrated the allied symptoms found on cardiovascular diseases. This paper deals with providing the accurate input for the atherosclerosis detection by way of image preprocessing method. The study focuses on the reducing the disease independent variations without damaging any information related to the differences between the images of healthy and atherosclerotic eyes. The propose method enables correction of illumination in the blood vessels, by repainting them. Further, there is a normalization of the focus region for the feature extraction and classification process. Finally, Enhanced Bayesian Arithmetic Classifier (EBAC) is implemented for effective classification of the blood vessels. MATLAB software of 2014b version is employed for deriving the simulation results. [ABSTRACT FROM AUTHOR]

Background This study examined the association between ideal cardiovascular health (CVH) and the retinal microvasculature in midadulthood. Methods and Results The Cardiovascular Risk in Young Finns Study included children from 5 Finnish University cities, who were chosen randomly from the national population register. Participants ranged from 12 to 18 years in childhood (1986) and from 37 to 43 years in midadulthood (2011). Ideal CVH was defined according to the American Heart Association criteria. Retinal microvascular measures included diameters, lengths, length:diameter ratio, and tortuosity. From childhood to adulthood, fasting plasma glucose and blood pressure were significantly higher in those with impaired fasting glucose or diabetes mellitus. Childhood ideal CVH was negatively associated with adult arteriolar tortuosity (β=−0.008; 95% confidence interval [CI], −0.01 to −0.003; P=0.001). Improved ideal CVH from childhood to adulthood was positively associated with adult arteriolar diameter (β=0.122; 95% CI, 0.01–0.24; P=0.033) and negatively associated with adult length:diameter ratio (β=−0.666; 95% CI, −1.25 to −0.08; P=0.026). When stratified by glucose metabolism, among those with diabetes mellitus and impaired fasting glucose, there was a negative association between childhood ideal CVH and adult venular diameter (diabetes mellitus: β=−2.75; 95% CI, −5.46 to −0.04; P=0.047; impaired fasting glucose: β=−2.13; 95% CI, −4.18 to −0.08; P=0.042). Conclusions This study is the first to comprehensively examine the impact of CVH from childhood to midadulthood on quantitative measures of the retinal microvasculature. Ideal CVH in childhood and improvement in CVH from childhood to adulthood appears to have a protective effect on the retinal microvasculature in those with, without, and at risk of diabetes mellitus.

Aims: To investigate changes in retinal vessel diameter during acute hyperglycemia in patients with type 1 diabetes.Methods: We conducted a study on 11 subjects with type 1 diabetes. Euglycemia was maintained for 3h followed by induction of hyperglycemia and simultaneous bolus of rapid acting insulin. Two fundus photos were captured during euglycemia and five fundus photos, blood glucose and blood pressure were taken every 30min for 2.5h post-prandial. Central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) were measured over the study visit and examined using generalized linear mixed models.Results: In a multivariate mixed model, mean CRAE and CRVE were reduced at 90min post-prandial in both zones B and C. In repeated measures analysis, arterioles exhibited a significant association with change in vessel caliber per change in blood glucose. Inconsistent effects of blood pressure on vessel diameter were also measured.Conclusions: We document a change in retinal vessel diameter during acute hyperglycemia in persons with type 1 diabetes. Larger controlled studies are required to further investigate this phenomenon and to more accurately assess if hyperglycemia has direct effects on retinal vessel diameter. [ABSTRACT FROM AUTHOR]

Purpose Sleep disordered breathing (SDB) is highly prevalent in older adults. Increasing evidence links SDB to the risk of dementia, mediated via a number of pathways, some of which may be attenuated by low-dose aspirin. This study will evaluate, in a healthy older cohort, the prospective relationship between SDB and cognitive function, changes in retinal and cerebral microvasculature, and determine whether low-dose aspirin ameliorates the effects of SDB on these outcomes over 3 years. Design SNORE-ASA is a sub-study of the ASPirin in Reducing Events in the Elderly (ASPREE) randomised, multi-centre, placebo-controlled trial evaluating the effect of daily 100 mg aspirin on disability-free and dementia-free survival in the healthy older adult aged 70 and over. At baseline, 1400 ASPREE participants successfully underwent a home sleep study with a home sleep study screening device for SDB; and 296 underwent both 1.5 Tesla brain magnetic resonance imaging (MRI) and retinal vascular imaging (RVI). Cognitive testing, brain MRI and RVI is being repeated after 3 years. Primary outcome measures Change in the modified mini-mental state examination score. Secondary outcome measures are changes in other cognitive tests, and changes in abnormal parameters on RVI and volume of white matter hyper-intensities on brain MRI. Conclusion Identifying preventive therapies for delaying the onset of dementia is of paramount importance. The results of this study will help clarify the impact of the SDB on risk of cognitive decline and cerebral small vessel disease, and whether low-dose aspirin can ameliorate cognitive decline in the setting of SDB. SNORE-ASA trial registration: ACTRN12612000891820 The Principal ASPREE study is registered with the International Standardized Randomized Controlled Trials Register, ASPirin in Reducing Events in the Elderly, Number: ISRCTN83772183 and clinicaltrials.gov Number NCT01038583. [ABSTRACT FROM AUTHOR]

Objective Type 1 diabetes mellitus (T1 DM) is a major disease affecting a large number of young patients. In the recent years, retinal vascular imaging has provided an objective assessment of vascular health in patients with T1 DM. Our study aimed to review the current literature on retinal vascular parameters in young patients with T1 DM in order to understand the following: (i) How retinal vessels are affected in T1 DM (ii) How such vascular changes can be predictive of future diabetic microvascular complications Methods We performed a systematic review and extracted relevant data from 17 articles. Results We found significant correlations between retinal vessel changes and diabetes-related risk factors (eg, hypertension, hyperlipidemia, and obesity), diabetes-related features (eg, diabetes duration and glycemic control), and diabetes-related microvascular complications (eg, diabetic retinopathy, nephropathy, and neuropathy). Conclusion Our findings suggest that retinal microvasculature is associated with both disease severity and complications in young patients with T1 DM. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between retinal vascular caliber and early age-related macular degeneration (AMD) in an Indian population. Methods: A total of 3112 Indian participants aged ≥40 years from the population-based Singapore Indian Eye Study who had data available on retinal vascular caliber measurements and AMD status were included. Retinal arteriolar and venular calibers were measured from digital photographs using computer-assisted software according to a standardized protocol. Images of the macular region were graded according to the modified Wisconsin age-related maculopathy grading system. Right eyes were selected for analyses. Binary logistic regression models were used to assess the association, adjusting for age, sex, systolic blood pressure, total cholesterol, random blood glucose, body mass index, and the companion retinal vascular caliber. Results: A total of 107 participants (3.4%) were diagnosed with early AMD. Neither arteriolar nor venular caliber was related to AMD. For early AMD, the age-, sex-, and companion retinal vascular caliber-adjusted odds ratio (OR) per standard deviation (SD) decrease in arteriolar caliber was 0.95 (95% CI 0.84-1.31; p = 0.671), and per SD increase in venular caliber was OR: 0.96 (95% CI: 0.77-1.20); p = 0.714. No trend was found after categorizing retinal vascular calibers into quartiles. Multivariate adjustment and stratified analyses did not alter these results. Conclusion: Retinal vascular calibers were not related to early AMD among Indian participants. These findings differ from those of several previous studies performed in Caucasian and Asian populations. [ABSTRACT FROM AUTHOR]

Endothelial dysfunction is a key pathogenic mechanism of CVD. The retinal microvascular network offers a unique, non-invasive window to study endothelial function. Recently, dynamic measurement of retinal vessel caliber using flicker light stimulation has been used to evaluate potential endothelial dysfunction and other mechanisms in CVD. A variety of studies now indicate that retinal vasodilation during flicker light simulation is reduced in diabetes, hypertension, hyperlipidemia and obesity, and may be influenced by age and race/ethnicity. These data suggest that flicker light-induced retinal vasodilation may be a unique and non-invasive measure of endothelial dysfunction. This review focuses recent studies on systemic associations of flicker light-induced retinal vasodilation, and discusses the potential for future research in this area. [ABSTRACT FROM AUTHOR]

The article summarizes the current understanding of the relationship between retinal vascular changes and blood pressure. Further development of retinal vascular analyses and standardized measurement protocols are suggested. Evaluation of the clinical use of retinal vascular imaging in assessing cardiovascular risk prediction and using retinal vascular imaging to test antihypertensive treatments allow the translation of retinal vascular imaging as a tool to improve hypertension treatment.

Purpose: Dilation of retinal vessels in response to diffuse luminance flicker may reflect endothelial function. Although this has previously been shown to be reproducible in whites, there have been no similar data in Asians. We assess the reproducibility of repeated measurements of this response in Asians. Material and Methods: Healthy Asians ( n = 33) with normal vision and no history of glaucoma, age-related macular degeneration, cataract, or retinal arterial/venous occlusion participated in this study. Repeated measures from the same subjects were taken 30–60 min apart using the Dynamic Vessel Analyser (DVA, IMEDOS, Jena, Germany). Modification was made to the shape of the light source for Asian participants. Correlations of the first and second measures were assessed using Pearson correlation ( R2), and agreement between the two measures was shown using Bland–Altman plots. Results: After modification to the shape of the light source, almost perfect correlation was found between the 1st and 2nd measurements of baseline arteriolar ( R2 = 0.95) and venular diameters ( R2 = 0.98) of arteriolar maximum dilation ( R2 = 0.85). Substantially high correlation between the 1st and 2nd measurements of venular maximum dilation was found ( R2 = 0.80). Conclusions: Measurements of the dilation response of retinal vessels to diffuse luminance flicker an Asian sample using the DVA show high reproducibility for repeated measures over a short period of time. Such measurements may allow non-invasive quantification of endothelial function to study its association with systemic and ocular diseases. [ABSTRACT FROM AUTHOR]

Background This study examined the association between ideal cardiovascular health ( CVH ) and the retinal microvasculature in midadulthood. Methods and Results The Cardiovascular Risk in Young Finns Study included children from 5 Finnish University cities, who were chosen randomly from the national population register. Participants ranged from 12 to 18 years in childhood (1986) and from 37 to 43 years in midadulthood (2011). Ideal CVH was defined according to the American Heart Association criteria. Retinal microvascular measures included diameters, lengths, length:diameter ratio, and tortuosity. From childhood to adulthood, fasting plasma glucose and blood pressure were significantly higher in those with impaired fasting glucose or diabetes mellitus. Childhood ideal CVH was negatively associated with adult arteriolar tortuosity (β=-0.008; 95% confidence interval [CI], -0.01 to -0.003; P=0.001). Improved ideal CVH from childhood to adulthood was positively associated with adult arteriolar diameter (β=0.122; 95% CI, 0.01-0.24; P=0.033) and negatively associated with adult length:diameter ratio (β=-0.666; 95% CI, -1.25 to -0.08; P=0.026). When stratified by glucose metabolism, among those with diabetes mellitus and impaired fasting glucose, there was a negative association between childhood ideal CVH and adult venular diameter (diabetes mellitus: β=-2.75; 95% CI , -5.46 to -0.04; P=0.047; impaired fasting glucose: β=-2.13; 95% CI, -4.18 to -0.08; P=0.042). Conclusions This study is the first to comprehensively examine the impact of CVH from childhood to midadulthood on quantitative measures of the retinal microvasculature. Ideal CVH in childhood and improvement in CVH from childhood to adulthood appears to have a protective effect on the retinal microvasculature in those with, without, and at risk of diabetes mellitus.

Background and Purpose: To examine the relationship between retinal microvascular measures and incident stroke in an Asian Malay population., Methods: We conducted a prospective, population-based cohort study of Asian Malay persons 40 to 80 years at baseline. Retinal microvascular signs were assessed from baseline retinal photographs including quantitative retinal microvascular parameters (caliber, branching angle, tortuosity, and fractal dimension) and qualitative retinopathy signs. Incident stroke cases were identified during the follow-up period. Cox proportional-hazards regression and incremental usefulness analysis (calibration, discrimination, and reclassification) were performed., Results: A total of 3189 participants were free of prevalent stroke at baseline. During the follow-up (median, 4.41 years), 51 (1.93%) participants had an incident stroke event. In Cox proportional-hazards models adjusting for established stroke predictors (age, sex, systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, smoking, glycosylated hemoglobin, and antihypertensive medication), retinopathy (hazard ratio, 1.94; 95% confidence interval, 1.01-3.72) and larger retinal venular caliber (hazard ratio, 3.28; 95% confidence interval, 1.30-8.26, comparing fourth versus first quartiles) were associated with risk of stroke. Compared with the model with only established risk factors, the addition of retinal measures improved the prediction of stroke (C-Statistic 0.826 versus 0.792; P=0.017) and correctly reclassified 5.9% of participants with incident stroke and 3.4% of participants with no incident stroke., Conclusions: Retinal microvascular changes are related to an increased risk of stroke in Asian Malay, consistent with data from white populations. Retinal imaging improves the discrimination and stratification of stroke risk beyond that of established risk factors by a significant but small margin.