Retinal Vasculature, Plasma Metabolites and Cardiovascular Disease Risk: A Prospective Cohort Study from the Canadian Longitudinal Study on Aging

BackgroundThis study aimed to investigate whether retinal fractal dimension (Df), a measure of microvascular branching complexity from fundus images, together with plasma metabolites, can help identify pathways linking microvascular changes to cardiovascular disease (CVD) events. MethodsWe analyzed longitudinal data from a subset of 4,781 participants from the Comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA), free of CVD at baseline (mean age 58.74 {+/-} 8.39; 47% male), and with 811 plasma metabolites measured at baseline and retinal imaging. Total, arterial and venular Df were derived from fundus photographs using the Vessel Assessment and Measurement Platform for Im