Effects of age and blood pressure on the retinal arterial wall, analyzed using adaptive optics scanning laser ophthalmoscopy

The wall-to-lumen ratio (WLR) of the vasculature is a promising early marker of retinal microvascular changes. Recently, adaptive optics scanning laser ophthalmoscopy (AOSLO) enabled direct and noninvasive visualization of the arterial wall. Using AOSLO, we analyzed the correlation between age and WLR in 51 normal subjects. In addition, correlations between blood pressure and WLR were analyzed in 73 subjects (51 normal subjects and 22 hypertensive patients). WLR showed a strong correlation with age (r = 0.68, P < 0.0001), while outer diameter and inner diameter did not show significant correlation with age in the normal group (r = 0.13, P = 0.36 and r = -0.12, P =  .41, respectively). In the normal and hypertensive groups, WLR showed a strong correlation with systolic and diastolic blood pressure (r = 0.60, P < 0.0001 and r = 0.65, P < 0.0001, respectively). In conclusion, AOSLO provided noninvasive and reproducible arterial measurements. WLR is an early marker of morphological changes in the retinal arteries due to age and blood pressure.