Increased retinal venular calibre in acute infections

Abstract Population-based studies have demonstrated that increased retinal venular calibre is a risk factor for cardiac disease, cardiac events and stroke. Venular dilatation also occurs with diabetes, obesity, dyslipidemia and autoimmune disease where it is attributed to inflammation. This study ex...

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Autores principales:	Cara Fitt, Thao Vi Luong, Damian Cresp, Anastasia Hutchinson, Karen Lim, Lauren Hodgson, Deb Colville, Judy Savige
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/914d1c488fa2438789a81994fd087e4a
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spelling	oai:doaj.org-article:914d1c488fa2438789a81994fd087e4a2021-12-02T15:09:15ZIncreased retinal venular calibre in acute infections10.1038/s41598-021-96749-y2045-2322https://doaj.org/article/914d1c488fa2438789a81994fd087e4a2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96749-yhttps://doaj.org/toc/2045-2322Abstract Population-based studies have demonstrated that increased retinal venular calibre is a risk factor for cardiac disease, cardiac events and stroke. Venular dilatation also occurs with diabetes, obesity, dyslipidemia and autoimmune disease where it is attributed to inflammation. This study examined whether the inflammation associated with infections also affected microvascular calibre. Participants with infections and CRP levels > 100 mg/L were recruited from the medical wards of a teaching hospital and assisted to complete a demographic and vascular risk factor questionnaire, and to undergo non-mydriatic retinal photography (Canon CR5-45NM, Japan). They were then treated with appropriate antibiotics, and underwent repeat retinal imaging when their CRP levels had fallen to less than 100 mg/L. Retinal images were examined for arteriole and venular calibre using validated semi-automated software based on Knudtson’s modification of the Parr-Hubbard formula (IVAN, U Wisconsin). Differences in inflammatory markers and calibre were examined using the paired t-test for continuous variables. Determinants of calibre were calculated from multiple linear regression analysis. Forty-one participants with respiratory (27, 66%), urinary (6, 15%), skin (5, 12%), or miscellaneous (3, 7%) infections were studied. After antibiotic treatment, participants’ mean CRP levels fell from 172.9 ± 68.4 mg/L to 42.2 ± 28.2 mg/L (p < 0.0001) and mean neutrophil counts fell from 9 ± 4 × 109/L to 6 ± 3 × 109/L (p < 0.0001). The participants’ mean venular calibre (CRVE) decreased from 240.9 ± 26.9 MU to 233.4 ± 23.5 MU (p = 0.0017) but arteriolar calibre (CRAE) was unchanged (156.9 ± 15.2 MU and 156.2 ± 16.0 MU, p = 0.84). Thirteen additional participants with infections had a CRP > 100 mg/L that persisted at review (199.2 ± 59.0 and 159.4 ± 40.7 mg/L, p = 0.055). Their CRAE and CRVE were not different before and after antibiotic treatment (p = 0.96, p = 0.78). Hospital inpatients with severe infections had retinal venular calibre that decreased as their infections resolved and CRP levels fell after antibiotic treatment. The changes in venular calibre with intercurrent infections may confound retinal vascular assessments of, for example, blood pressure control and cardiac risk.Cara FittThao Vi LuongDamian CrespAnastasia HutchinsonKaren LimLauren HodgsonDeb ColvilleJudy SavigeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Cara Fitt Thao Vi Luong Damian Cresp Anastasia Hutchinson Karen Lim Lauren Hodgson Deb Colville Judy Savige Increased retinal venular calibre in acute infections
description	Abstract Population-based studies have demonstrated that increased retinal venular calibre is a risk factor for cardiac disease, cardiac events and stroke. Venular dilatation also occurs with diabetes, obesity, dyslipidemia and autoimmune disease where it is attributed to inflammation. This study examined whether the inflammation associated with infections also affected microvascular calibre. Participants with infections and CRP levels > 100 mg/L were recruited from the medical wards of a teaching hospital and assisted to complete a demographic and vascular risk factor questionnaire, and to undergo non-mydriatic retinal photography (Canon CR5-45NM, Japan). They were then treated with appropriate antibiotics, and underwent repeat retinal imaging when their CRP levels had fallen to less than 100 mg/L. Retinal images were examined for arteriole and venular calibre using validated semi-automated software based on Knudtson’s modification of the Parr-Hubbard formula (IVAN, U Wisconsin). Differences in inflammatory markers and calibre were examined using the paired t-test for continuous variables. Determinants of calibre were calculated from multiple linear regression analysis. Forty-one participants with respiratory (27, 66%), urinary (6, 15%), skin (5, 12%), or miscellaneous (3, 7%) infections were studied. After antibiotic treatment, participants’ mean CRP levels fell from 172.9 ± 68.4 mg/L to 42.2 ± 28.2 mg/L (p < 0.0001) and mean neutrophil counts fell from 9 ± 4 × 109/L to 6 ± 3 × 109/L (p < 0.0001). The participants’ mean venular calibre (CRVE) decreased from 240.9 ± 26.9 MU to 233.4 ± 23.5 MU (p = 0.0017) but arteriolar calibre (CRAE) was unchanged (156.9 ± 15.2 MU and 156.2 ± 16.0 MU, p = 0.84). Thirteen additional participants with infections had a CRP > 100 mg/L that persisted at review (199.2 ± 59.0 and 159.4 ± 40.7 mg/L, p = 0.055). Their CRAE and CRVE were not different before and after antibiotic treatment (p = 0.96, p = 0.78). Hospital inpatients with severe infections had retinal venular calibre that decreased as their infections resolved and CRP levels fell after antibiotic treatment. The changes in venular calibre with intercurrent infections may confound retinal vascular assessments of, for example, blood pressure control and cardiac risk.
format	article
author	Cara Fitt Thao Vi Luong Damian Cresp Anastasia Hutchinson Karen Lim Lauren Hodgson Deb Colville Judy Savige
author_facet	Cara Fitt Thao Vi Luong Damian Cresp Anastasia Hutchinson Karen Lim Lauren Hodgson Deb Colville Judy Savige
author_sort	Cara Fitt
title	Increased retinal venular calibre in acute infections
title_short	Increased retinal venular calibre in acute infections
title_full	Increased retinal venular calibre in acute infections
title_fullStr	Increased retinal venular calibre in acute infections
title_full_unstemmed	Increased retinal venular calibre in acute infections
title_sort	increased retinal venular calibre in acute infections
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/914d1c488fa2438789a81994fd087e4a
work_keys_str_mv	AT carafitt increasedretinalvenularcalibreinacuteinfections AT thaoviluong increasedretinalvenularcalibreinacuteinfections AT damiancresp increasedretinalvenularcalibreinacuteinfections AT anastasiahutchinson increasedretinalvenularcalibreinacuteinfections AT karenlim increasedretinalvenularcalibreinacuteinfections AT laurenhodgson increasedretinalvenularcalibreinacuteinfections AT debcolville increasedretinalvenularcalibreinacuteinfections AT judysavige increasedretinalvenularcalibreinacuteinfections
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Increased retinal venular calibre in acute infections

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