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  1. Tai EL, Li LJ, Wan-Hazabbah WH, Wong TY, Shatriah I
    PLoS One, 2017;12(1):e0170014.
    PMID: 28107389 DOI: 10.1371/journal.pone.0170014
    PURPOSE: Retinal vessel analysis is affected by both systemic and ocular factors. Malays are the major ethnicity in South East Asia. Data on the retinal microvasculature in Malays is limited, especially among children. We aim to evaluate the influence of ocular biometry on retinal vessel parameters in young Malay girls.

    METHODS: This was a cross-sectional, hospital-based study involving 86 Malay girls aged 6 to 12 years old in Hospital Universiti Sains Malaysia from 2015-2016. Ocular examination, refraction, biometry, retinal photography, and anthropometric measurements were performed. The central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) and overall fractal dimension (Df) were measured using validated computer-based methods (Singapore I vessel analyzer, SIVA version 3.0, Singapore). The associations of ocular biometry and CRAE, CRVE and Df were analyzed using multivariable analysis.

    RESULTS: The mean CRAE, CRVE and Df in Malay girls were 171.40 (14.40) um, 248.02 (16.95) um and 1.42 (0.05) respectively. Each 1 mm increase in axial length was associated with a reduction of 4.25 um in the CRAE (p = 0.03) and a reduction of 0.02 in the Df (p = 0.02), after adjustment for age, blood pressure and body mass index. No association was observed between axial length and CRVE. Anterior chamber depth and corneal curvature had no association with CRAE, CRVE or Df.

    CONCLUSION: Axial length affects retinal vessel measurements. Narrower retinal arterioles and reduced retinal fractal dimension were observed in Malay girls with longer axial lengths.

    Matched MeSH terms: Retinal Vessels/anatomy & histology*
  2. Tai ELM, Kueh YC, Wan Hitam WH, Wong TY, Shatriah I
    PLoS One, 2018;13(2):e0191434.
    PMID: 29389952 DOI: 10.1371/journal.pone.0191434
    PURPOSE: Childhood obesity is associated with adult cardiometabolic disease. We postulate that the underlying microvascular dysfunction begins in childhood. We thus aimed to compare retinal vascular parameters between obese and non-obese children.

    METHODS: This was a cross-sectional study involving 166 children aged 6 to 12 years old in Malaysia. Ocular examination, biometry, retinal photography, blood pressure and body mass index measurement were performed. Participants were divided into two groups; obese and non-obese. Retinal vascular parameters were measured using validated software.

    RESULTS: Mean age was 9.58 years. Approximately 51.2% were obese. Obese children had significantly narrower retinal arteriolar caliber (F(1,159) = 6.862, p = 0.010), lower arteriovenous ratio (F(1,159) = 17.412, p < 0.001), higher venular fractal dimension (F(1,159) = 4.313, p = 0.039) and higher venular curvature tortuosity (F(1,158) = 5.166, p = 0.024) than non-obese children, after adjustment for age, gender, blood pressure and axial length.

    CONCLUSIONS: Obese children have abnormal retinal vascular geometry. These findings suggest that childhood obesity is characterized by early microvascular abnormalities that precede development of overt disease. Further research is warranted to determine if these parameters represent viable biomarkers for risk stratification in obesity.

    Matched MeSH terms: Retinal Vessels/anatomy & histology*
  3. Saleh MD, Eswaran C, Mueen A
    J Digit Imaging, 2011 Aug;24(4):564-72.
    PMID: 20524139 DOI: 10.1007/s10278-010-9302-9
    This paper focuses on the detection of retinal blood vessels which play a vital role in reducing the proliferative diabetic retinopathy and for preventing the loss of visual capability. The proposed algorithm which takes advantage of the powerful preprocessing techniques such as the contrast enhancement and thresholding offers an automated segmentation procedure for retinal blood vessels. To evaluate the performance of the new algorithm, experiments are conducted on 40 images collected from DRIVE database. The results show that the proposed algorithm performs better than the other known algorithms in terms of accuracy. Furthermore, the proposed algorithm being simple and easy to implement, is best suited for fast processing applications.
    Matched MeSH terms: Retinal Vessels/anatomy & histology*
  4. Ahmad Fadzil MH, Izhar LI, Venkatachalam PA, Karunakar TV
    J Med Eng Technol, 2007 Nov-Dec;31(6):435-42.
    PMID: 17994417 DOI: 10.1080/03091900601111201
    Information about retinal vasculature morphology is used in grading the severity and progression of diabetic retinopathy. An image analysis system can help ophthalmologists make accurate and efficient diagnoses. This paper presents the development of an image processing algorithm for detecting and reconstructing retinal vasculature. The detection of the vascular structure is achieved by image enhancement using contrast limited adaptive histogram equalization followed by the extraction of the vessels using bottom-hat morphological transformation. For reconstruction of the complete retinal vasculature, a region growing technique based on first-order Gaussian derivative is developed. The technique incorporates both gradient magnitude change and average intensity as the homogeneity criteria that enable the process to adapt to intensity changes and intensity spread over the vasculature region. The reconstruction technique reduces the required number of seeds to near optimal for the region growing process. It also overcomes poor performance of current seed-based methods, especially with low and inconsistent contrast images as normally seen in vasculature regions of fundus images. Simulations of the algorithm on 20 test images from the DRIVE database show that it outperforms many other published methods and achieved an accuracy range (ability to detect both vessel and non-vessel pixels) of 0.91 - 0.95, a sensitivity range (ability to detect vessel pixels) of 0.91 - 0.95 and a specificity range (ability to detect non-vessel pixels) of 0.88 - 0.94.
    Matched MeSH terms: Retinal Vessels/anatomy & histology*
  5. Ab Hamid F, Che Azemin MZ, Salam A, Aminuddin A, Mohd Daud N, Zahari I
    Curr. Eye Res., 2016 Jun;41(6):823-31.
    PMID: 26268475 DOI: 10.3109/02713683.2015.1056375
    PURPOSE: The goal of this study was to provide the empirical evidence of fractal dimension as an indirect measure of retinal vasculature density.

    MATERIALS AND METHODS: Two hundred retinal samples of right eye [57.0% females (n = 114) and 43.0% males (n = 86)] were selected from baseline visit. A custom-written software was used for vessel segmentation. Vessel segmentation is the process of transforming two-dimensional color images into binary images (i.e. black and white pixels). The circular area of approximately 2.6 optic disc radii surrounding the center of optic disc was cropped. The non-vessels fragments were removed. FracLac was used to measure the fractal dimension and vessel density of retinal vessels.

    RESULTS: This study suggested that 14.1% of the region of interest (i.e. approximately 2.6 optic disk radii) comprised retinal vessel structure. Using correlation analysis, vessel density measurement and fractal dimension estimation are linearly and strongly correlated (R = 0.942, R(2) = 0.89, p 

    Matched MeSH terms: Retinal Vessels/anatomy & histology*
  6. Jeganathan VS, Sabanayagam C, Tai ES, Lee J, Sun C, Kawasaki R, et al.
    Hypertens. Res., 2009 Nov;32(11):975-82.
    PMID: 19713968 DOI: 10.1038/hr.2009.130
    Blood pressure has a significant effect on retinal arterioles. There are few data on whether this effect varies by race/ethnicity. We examined the relationship of blood pressure and retinal vascular caliber in a multi-ethnic Asian population. The study is population-based and cross sectional in design. A total of 3749 Chinese, Malay and Indian participants aged > or =24 years residing in Singapore were included in the study. Retinal vascular caliber was measured using a computer program from digital retinal photographs. The associations of retinal vascular caliber with blood pressure and hypertension in each racial/ethnic group were analyzed. The main outcome measures are retinal arteriolar caliber and venular caliber. The results show that retinal arterioles were narrower in persons with uncontrolled/untreated hypertension (140.0 microm) as compared with persons with controlled hypertension (142.1 microm, P=0.0001) and those with no hypertension (146.0 microm, P<0.0001). On controlling for age, gender, body mass index, lipids and smoking, each 10 mm Hg increase in mean arterial blood pressure was associated with a 3.1 microm decrease in arteriolar caliber (P<0.0001), with a similar magnitude seen in all three racial/ethnic groups: 3.1 microm in Chinese, 2.8 microm in Malays and 3.2 microm in Indians (P<0.0001 for all). Each 10 mm Hg increase in mean arterial blood pressure was associated with a 1.8 microm increase in venular caliber (P<0.0001); furthermore, the magnitude of this effect was similar across the three racial/ethnic groups. The effect of blood pressure on the retinal vasculature was similar across three major racial/ethnic groups in Asia.
    Matched MeSH terms: Retinal Vessels/anatomy & histology
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