OBJECTIVE -To examine the relationship of retinal vascular caliber with diabetes, glycemia, and diabetic retinopathy.RESEARCH DESIGN AND METHODS -Population-based study using data from the Multi-Ethnic Study of Atherosclerosis (MESA), comprising 5,976 individuals (whites, blacks, Hispanics, and Chinese) residing in six U.S. communities who were free of clinical cardiovascular disease at baseline. Retinal vascular caliber was measured from digital retinal photographs.RESULTS -There were 4,585 individuals with normal fasting glucose (NFG), 499 with impaired fasting glucose (IFG), 165 with diabetes with retinopathy signs, and 727 with diabetes without retinopathy signs. After multivariate analysis, retinal arteriolar caliber increased from 143.8 m in subjects with NFG to 144.5 m in IFG and 146.1 m in diabetes (P Ͻ 0.001 for trend). Retinal venular caliber increased from 214.4 m in NFG to 216.7 m in IFG and 218.0 m in diabetes (P Ͻ 0.001 for trend). Retinal venular caliber was significantly larger with increasing levels of fasting glucose and A1C. In a subgroup analysis by ethnicity, the association between wider arteriolar caliber and diabetes was evident in whites only, whereas wider venular caliber and diabetes was evident in Hispanics and Chinese only. In people with diabetes, eyes with retinopathy had larger retinal venular but not arteriolar caliber.CONCLUSIONS -Retinal arteriolar and venular calibers are larger in individuals with diabetes, but the pattern of associations appears to vary by ethnicity. Retinal venular caliber is additionally associated with retinopathy signs. These findings add further to the concept that variations in retinal vascular caliber may reflect early diabetic microvascular damage.
Diabetes Care 31:544-549, 2008
Aim/hypothesis The aim of this hypothesis was to examine the association of retinal vessel tortuosity with diabetes and diabetic retinopathy (DR). Methods A clinic-based study of 327 participants (224 with diabetes and 103 non-diabetic controls) aged ≥18 years. DR was graded from fundus photographs according to the modified Airlie House Classification system and categorised into mild non-proliferative DR (NPDR), moderate NPDR and vision-threatening DR (VTDR). Retinal vessel tortuosity was measured from disc-centred retinal photographs. Measurements were taken, using a semiautomated computer program by a single grader, of arterioles and venules within 0.5 to 2 disc diameters away from the optic disc. Results There were 114 (44%)
Endovascular cooling can be performed safely as an adjunct to primary PCI for AMI. Further clinical trials are required to determine whether induction of mild systemic hypothermia with endovascular cooling will limit infarct size in patients undergoing reperfusion therapy.
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