Abstract

PURPOSE: To examine retinal vasculometry associations with different glaucomas in older British people. DESIGN: Cross-sectional study METHODS: 8,623 European Prospective Investigation into Cancer-Norfolk Eye study participants were examined, who underwent retinal imaging, ocular biometry assessment, and clinical ascertainment of ocular hypertensive or glaucoma status (including glaucoma suspect [GS], high tension open-angle glaucoma [HTG], and normal tension glaucoma [NTG]). Automated measures of arteriolar and venular tortuosity, area and width from retinal images were obtained. MAIN OUTCOME MEASURES: Associations between glaucoma and retinal vasculometry outcomes were analysed using multi-level linear regression, adjusted for age, sex, height, axial length, intra ocular and systemic blood pressure, and within-person clustering, to provide absolute differences in width and area, and percentage differences in vessel tortuosity. Presence or absence of within-person-between-eye differences in retinal vasculometry by diagnoses were examined. RESULTS: 565,593 vessel segments from 5,947 participants (mean age 67.6, SD 7.6 years, 57% women) were included; numbers with HTG, NTG and GS in at least one eye were 87, 82, 439 respectively. Thinner arterioles (-3.2μm; 95%CI -4.4,-1.9μm) and venules (-2.7μm; 95%CI -4.9,-0.5μm) were associated with HTG. Reduced venular area was associated with HTG (-0.2mm2; 95%CI -0.3,-0.1mm2) and NTG (-0.2mm2; 95%CI -0.3,-0.0mm2). Less tortuous retinal arterioles and venules were associated with all glaucomas, but only significantly for GS (-3.9%; 95%CI -7.7,-0.1% and -4.8%; 95%CI -7.4,-2.1% respectively). There was no evidence of within-person-between-eye differences in retinal vasculometry associations by diagnoses. CONCLUSIONS: Retinal vessel width associations with glaucoma and novel associations with vessel area and tortuosity, together with no evidence of within-person-between-eye differences in retinal vasculometry, suggest a vascular cause of glaucoma.