Objective: Wall-to-lumen ratio of retinal arterioles represents a potential future parameter for vascular damage. We hypothesized that changes in wall-to-lumen ratio of retinal arterioles is associated with alterations of aortic pulse wave in patients with a history of a cerebrovascular event.

Methods: In this pilot study 14 patients (5 female and 9 male patients) with a mean age of 60.2±9.8 years, mean blood pressure levels of 132±14/79.1±11 mmHg and a history of a cerebrovascular event have been enrolled. Wall-to-lumen ratio of retinal arterioles was assessed in vivo using scanning laser Doppler flowmetry (Heidelberg Retina Flowmetry, Heidelberg, Germany). Pulse wave analysis to determine aortic augmentation index and aortic augmentation pressure were performed in vivo using applanation tonometry (SphygmoCor, AtCor Medical PtyLtd, NSW 2114, Australia).

Results: Pulse pressure (r=0.593, p=0.025), but not systolic, diastolic or mean arterial pressure was related to wall-to-lumen ratio of retinal arterioles. Age, body mass index, waist circumference as well as parameters of glucose and lipid profile did not reveal a relation to wall-to-lumen ratio of retinal arterioles. Aortic augmentation index (r=0.546, p=0.043) and aortic augmentation pressure (r=0.559, p=0.038) were both related to wall-to-lumen ratio of retinal arterioles even when aortic augmentation index and aortic augmentation pressure were corrected for a mean heart rate of 75 bpm (r=0.572, p=0.032 and r=0.616, p=0.019; respectively).

Conclusion: In our cohort of patients with a history of a cerebrovascular event wall-to-lumen ratio of retinal arterioles was related to alterations of aortic pulse wave thereby indicating parallel vascular changes in the micro- and macrovasculature.