40岁以上中老年人视网膜血管弯曲度的横断面调查—北京眼病研究

目的 描述40岁及以上中老年人视网膜血管的弯曲度及其人群分布特征。设计  横断面研究。研究对象 北京眼病研究基线人群。方法 采用定量测量软件（SIVA3.0）对3901例受检者随机一眼的彩色眼底照片中的视网膜血管弯曲度指标进行测量。按年龄分为40~44岁、45~49岁、50~54岁、55~59岁、60~64岁及65岁以上组。测量分区：距视盘边缘0.5~1 PD之间的环形区域为B区，距视盘边缘0.5~2 PD之间环形的区域为C区。测量指标包括视网膜动脉简单弯曲度（sTORTa）、视网膜动脉曲率弯曲度（cTORTa）；视网膜静脉简单弯曲度（sTORTv）、视网膜静脉曲率弯曲度（cTORTv）。多因素分析血管弯曲度与年龄、性别、BMI及问卷调查中高血压、糖尿病、冠心病、脑卒中、吸烟和饮酒等因素的关系。主要指标 sTORTa、cTORTa、sTORTv、cTORTv。结果 3901例受试者的sTORTa和cTORTa分别为1.087±0.021和0.0000291±0.0000071；sTORTv和cTORTv分别为1.098±0.019和0.0000356±0.0000079。不同年龄组间的TORTa有明显统计学差异，随年龄增长动脉弯曲度逐渐下降（P均=0.000）。男性的cTORTa比女性稍小（P=0.034）。不同年龄组间的sTORTv无明显差异（P=0.169），cTORTv则随年龄增长稍有增加（P=0.022）。不同性别间TORTv无统计学差异（P均＞0.05）。多因素分析结果表明，sTORTa与年龄（r=-0.001, P=0.013）相关，cTORTa与年龄（r=-4.21E-8, P＜0.0001）、BMI（r=-5.64E-8, P＜0.0001）和高血压（r=-8.16E-8, P＜0.0001）相关；sTORTv与BMI（r=0.001, P=0.008）相关，cTORTv与年龄（r=4.36E-8, P＜0.0001）、BMI（r=1.16E-7, P＜0.0001）、高血压（r=1.36E-9, P＜0.0001）和高血脂（r=-8.85E-8, P＜0.0001）相关。结论 40岁以上的人随年龄增长视网膜动脉逐渐变直，而视网膜静脉弯曲度则稍有增大。男性的视网膜动脉弯曲度较女性稍小。视网膜动脉走行较直与年龄较大、血压和BMI较高相关；视网膜静脉走行弯曲与BMI和血压较高及血脂水平较低相关。（眼科，2021，30： 97-101）

Cross-sectional study of retinal vascular tortuosity in elderly population-Beijing Eye Study

Objective To quantitatively describe the population distribution characteristics of retinal vascular tortuosity in elderly population.Design Cross-sectional study.Participants Baseline population of Beijing Eye Study.Methods Quantitative measurement software(Singapore I Vessel Assessment,SIVA 3.0)was used to measure the parameters of retinal vascular tortuosity in color fundus photographs selected from 3901 subjects.One eye of each participant was randomly selected.The study population was divided into 6 groups:40-44,45-49,50-54,55-59,60-64 and age of 60+years.The region from 0.5 to 1 PD away from the disc margin was zone B,0.5-2 PD away from the disc margin was zone C.Parameters include simple tortuosity arteriole(sTORTa),curvaturetor tuosity arteriole(cTORTa),simple tortuosity venue(sTORTv),curvature tortuosity venule(cTORTv).The distribution of population,age and gender of these indicators was described and the relationship between retinal vascular tortuosity and related factors such as age,gender,BMI and hypertension,diabetes,coronary heart disease,stroke,smoking and drinking from the questionnaire were analyzed with multivariate analysis.Main Outcome Measures sTORTa,cTORTa,sTORTv,cTORTv.Results The sTORTa and cTORTa of 3901 subjects was 1.087±0.021 and 0.0000291±0.0000071,respectively.The sTORTv and cTORTv was 1.098±0.019 and 0.0000356±0.0000079,respectively.The TORTa in different age groups was significantly different(P=0.000),the indicator gradually decreased with age.Men's cTORTa was smaller than women's(all P=0.034).There was no significant difference in sTORTv between different age groups(P=0.169),but cTORTv was gradually increased with age(P=0.022).There was no difference in sTORTv between different genders(P=0.141).Multivariate analysis showed that sTORTa was associated with age(r=-0.001,P=0.013).cTORTa was associated with age(r=-4.21E-8,P<0.0001),BMI(r=-5.64E-8,P<0.0001)and hypertension(r=-8.16E-8,P<0.0001).sTORTv was associated with BMI(r=0.001,P=0.008).cTORTv was associated with age(r=4.36E-8,P<0.0001),BMI(r=1.16E-7,P<0.0001),hypertension(r=1.36E-9,P<0.0001)and hyperlipemia(r=-8.85E-8,P<0.0001).Conclusion In population with 40 years or older,retinal arteries tend to straighten with age,while cTORTv was slightly increased with age.Men's cTORTa was smaller than women's.The retinal artery with a straight shape was associated with older age,higher blood pressure and BMI;the curved retinal vein was associated with higher BMI,higher blood pressure and lower levels of blood lipids.