Retinal vessel diameter in children may offer window into future CVD risk

Currently, retinal vessel diameters are not a strong contender for clinical risk prediction, Alan E. Simon, MD, and Matthew W. Gillman, MD, wrote in an editorial commenting on the study by Köchli et al.

However, the concept has “intuitive appeal because the eye provides the opportunity to view systemic arteries and veins directly,” wrote Dr. Simon and Dr. Gillman.

The association between childhood retinal vessel diameters and cardiovascular endpoints in adults has not been evaluated, understandably, because of the very long follow-up that would be required. And even though studies have suggested that there might be some small added benefit for women in adding adult retinal vessel diameters to other cardiovascular risk prediction scores, the same does not appear to be true for men.

Even if childhood retinal vessel diameters had strong predictive value, it’s still not clear whether the retinal vessel evaluation would be useful for pediatricians grouping patients into risk categories for strokes or heart attacks at some point in the future.

Likewise, using retinal vessel diameters as an outcome measure in clinical trials is not justified at present, although that could change in the future.

“As technological advances make this novel assessment more available to clinicians, we hope that such availability is accompanied by additional evidence for or against its usefulness among clinicians and researchers,” the authors said in the editorial.