The role of retinal vessels caliber as a marker of vascular aging in large arteries

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To analyze the relationship between retinal vessel caliber and large arterial structure and function in a sample of the general population.


A cross-sectional study was conducted among 229 participants from the EVIDENT trial (mean age 55.6±12.1 years, 61.1% women). Retinal photographs were digitized, temporal vessels were measured in an area of 0.5 to 1 disc diameter from the optic disc and the arterio-venous ratio (AVR) was estimated. Vascular structure and function were assessed by evaluating carotid intima–media thickness (IMT), pulse wave velocity (PWV), augmentation index (AIx), ankle brachial index and ambulatory arterial stiffness index.


The mean AVR was 0.792 ± 0.082, calculated from an arterial caliber of 109.1 ± 12.5 μm and a venous caliber of 138.7 ± 15.4 μm. A total of 13.1% of the patients presented vascular damage. The AVR was inversely correlated with carotid IMT (r = −0.190, P < 0.01), PWV (r = −0.178, P < 0.01) and AIx (r = −0.187, P < 0.01). In a multiple linear regression analysis, the associations with IMT and with AIx remained after adjusting for possible confounders (β = −0.152, P = 0.026; and β = −18.1, P = 0.037, respectively), but the association with PWV was lost when blood pressure was added (β = −1.520, P = 0.215). In a logistic regression analysis, the odds ratio of the first tertile of mean AVR (<0.76) of having a vascular injury was 7.09 (95% confidence interval 1.78–28.17, P = 0.011) after adjusting for possible confounders.


In the general population, lower AVR values are associated with increases in carotid IMT, AIx and PWV. AVR may be a good predictor of asymptomatic vascular damage in large arteries.

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