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. 2021 Nov 1;10(13):25.
doi: 10.1167/tvst.10.13.25.

Retinal Blood Velocity Waveform Characteristics With Aging and Arterial Stiffening in Hypertensive and Normotensive Subjects

Yoshitaka Takizawa  1 , Youngseok Song  1 , Tomofumi Tani  1 , Takafumi Yoshioka  1 , Kengo Takahashi  1 , Tsubasa Abe  1 , Tomoko Ro-Mase  1 , Satoshi Ishiko  1 , Jun Sakai  2 , Kana Minamide  2 , Masahiro Akiba  2 , Takamitsu Tatsukawa  3 , Nobuyoshi Azuma  3 , Akitoshi Yoshida  1
Affiliations

Retinal Blood Velocity Waveform Characteristics With Aging and Arterial Stiffening in Hypertensive and Normotensive Subjects

Yoshitaka Takizawa et al. Transl Vis Sci Technol. .

Abstract

Purpose: We aimed to explore the velocity waveform characteristics of the retinal artery associated with age and the cardio-ankle vascular index (CAVI) as a conventional arterial stiffness marker by applying the Doppler optical coherence tomography (DOCT) flowmeter.

Methods: In this cross-sectional study, DOCT flowmeter imaging was performed in 66 participants aged 21 to 83 years (17 men, 49 women) with no history of eye diseases and no systemic diseases, except for hypertension. Retinal blood velocity waveform was analyzed where several parameters in time (upstroke time, T1, T2, T3, and T4) and area under the waveform (area elevation, area declination, A1, A2, A3, and A4) were extracted. Systolic blood pressure-adjusted Pearson's coefficients were calculated to determine the correlations of each parameter with age or CAVI.

Results: Corrected upstroke time (UTc) was the waveform parameter most positively correlated with age (r = 0.497, P < 0.001). Area declination was the waveform parameter most negatively correlated with age (r = -0.682, P < 0.001) and CAVI (r = -0.601, P < 0.001).

Conclusions: We extracted the waveform parameters associated with the risks of arterial stiffening. The velocity waveform analysis of the retinal artery with DOCT flowmeter potentially could become a new method for arterial stiffness identification.

Translational relevance: DOCT flowmeter could evaluate arterial stiffening in a different way from the conventional method of measuring arterial stiffening using pressure waveform. Because the DOCT flowmeter can easily, quickly, and noninvasively provide a retinal blood velocity waveform, this system could be useful as a routine medical examination for arterial stiffening.

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Conflict of interest statement

Disclosure: Y. Takizawa, None; Y. Song, None; T. Tani, None; T. Yoshioka, None; K. Takahashi, None; T. Abe, None; T. Ro-Mase, None; S. Ishiko, None; J. Sakai, Topcon Corporation (E); K. Minamide, Topcon Corporation (E); M. Akiba, Topcon Corporation (E); T. Tatsukawa, None; N. Azuma, None; A. Yoshida, DOCT flowmeter #2013-184018 (P)

Figures

Figure 1.
Figure 1.
Example of retinal blood flow measurement in a temporal artery. (A) Color fundus image and scanning location (arrow) of DOCT imaging. (B) Two alternative scans captured 200 µm apart across the blood vessel to estimate the Doppler angle using triangular calculation. (C) OCT image. (D) Phase image with color coding. (E) Acquired blood velocity waveform.
Figure 2.
Figure 2.
Definitions of blood flow parameters from a blood velocity waveform. (A) Original waveform. Determination of maximum (Vmax) and minimum (Vmin) blood flow velocity. Determination of “upstroke time (UT)” as the transit time from Vmin to Vmax, “area elevation” as the area under the normalized waveform on UT, “area total” as an area on one cardiac cycle, and “area declination” as a subtracted area: area total minus area elevation. (B) Normalized waveform in both the velocity (0 to 1) and time (0 to 100). Determination of T1 as the normalized time from 0 to 0.5 in speeding up velocity, T2 as the time from 0.5 to 1, T3 as the time from 1 to 0.5 in slowing down velocity, and T4 as the time from 0.5 to 0. Determination of A1 as an area under the waveform on T1, A2 as an area on T2 above velocity 0.5, A3 as an area on T3 above velocity 0.5, and A4 as an area on T4.
Figure 3.
Figure 3.
Representative velocity of the retinal artery in young adults with low CAVI (A, B) and older adults with high CAVI (C, D). A dicrotic notch (circle) and increased velocity in early diastole (arrow) found in young adults.
See this image and copyright information in PMC

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