Determinants of Retinal Venular Diameter: The Beaver Dam Eye Study

Myers, Chelsea E.; Klein, Ronald; Knudtson, Michael D.; Lee, Kristine E.; Gangnon, Ronald E.; Wong, Tien Yin; Klein, Barbara E.K.

doi:10.1016/j.ophtha.2012.06.038

Cited by 54 publications

(55 citation statements)

References 53 publications

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“…Smaller venules were shown to be associated with higher mean arterial BP and higher serum HDL cholesterol (16). Smoking, on the other hand, was reported to be associated with larger arterioles (17).…”

Section: Discussionmentioning

confidence: 97%

“…The score, which is derived from the presence and severity of the above-mentioned abnormalities, is on an ordinal scale and is not a continuous variable. Scores were classified as normal (,14), very mild nonproliferative retinopathy (NPR; [14][15][16][17][18][19][20], NPR (35-53), and proliferative retinopathy (PR; .60). The score for the eye with more advanced retinopathy was used as the score of the participant; when photographs of only one eye were available, the score for that eye was used.…”

Section: Retinopathy and Vessel Caliber Assessment Protocolsmentioning

confidence: 99%

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Retinopathy and Progression of CKD

Grunwald

Pistilli

Ying

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Retinal abnormalities may be associated with changes in the renal vasculature. This study assessed the association between retinopathy and progression of kidney disease in participants of the Chronic Renal Insufficiency Cohort (CRIC) study.Design, setting, participants, & measurements This was a prospective study in which patients with CKD enrolled in CRIC had nonmydriatic fundus photographs of both eyes. All CRIC participants in six clinical sites in which fundus cameras were deployed were offered participation. Photographs were reviewed at a reading center. The presence and severity of retinopathy and vessel calibers were assessed using standard protocols by graders masked to clinical information. The associations of retinal features with changes in eGFR and the need for RRT (ESRD) were assessed.Results Retinal images and renal progression outcomes were obtained from 1852 of the 2605 participants (71.1%) approached. During follow-up (median 2.3 years), 152 participants (8.2%) developed ESRD. Presence and severity of retinopathy at baseline were strongly associated with the risk of subsequent progression to ESRD and reductions in eGFR in unadjusted analyses. For example, participants with retinopathy were 4.4 times (95% confidence interval [95% CI], 3.12 to 6.31) more likely to develop ESRD than those without retinopathy (P,0.001). However, this association was not statistically significant after adjustment for initial eGFR and 24-hour proteinuria. Venular and arteriolar diameter calibers were not associated with ESRD or eGFR decline. The results showed a nonlinear relationship between mean ratio of arteriole/vein calibers and the risk of progression to ESRD; participants within the fourth arteriole/vein ratio quartile were 3.11 times (95% CI, 1.51 to 6.40) more likely to develop ESRD than those in the first quartile (P,0.001).Conclusions The presence and severity of retinopathy were not associated with ESRD and decline in eGFR after taking into account established risk factors.

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Section: Discussionmentioning

confidence: 97%

Section: Retinopathy and Vessel Caliber Assessment Protocolsmentioning

confidence: 99%

Retinopathy and Progression of CKD

Grunwald

Pistilli

Ying

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. 42,44 PTH and FGF23 were not measured in the BDES.…”

Section: Methodsmentioning

confidence: 93%

Serum Phosphate and Retinal Microvascular Changes: The Multi-Ethnic Study of Atherosclerosis and the Beaver Dam Eye Study

Mehta

Hodakowski

Cai

et al. 2017

Ophthalmic Epidemiology

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Purpose Higher levels of serum phosphate are strongly linked to increased risk of cardiovascular disease and therapies aimed to lower serum phosphate are employed in the management of patients with chronic kidney disease (CKD). Data are limited, however, on serum phosphate as a risk factor for microvascular disease in community-based populations. It is important to determine the impact of novel risk factors, such as phosphate, on the microvasculature. Methods We conducted a prospective study of 3919 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA) and 3544 individuals in the Beaver Dam Eye Study (BDES) to test the associations of serum phosphate with retinopathy and retinal vessel caliber, and change in retinopathy severity and change in retinal vessel caliber. Results Mean (standard deviation) serum phosphate was 3.66 (0.52) mg/dl in the MESA and 3.77 (0.55) mg/dl in the BDES. In multivariable adjusted models, phosphate was significantly associated with prevalent retinopathy in the MESA (Odds Ratio [OR] per 1 mg/dl increase in phosphate, 1.22; Confidence Interval [CI] 1.02–1.47) and the BDES (OR 1.06; CI 1.01–1.11). In stratified analyses, these relationships were even stronger and only seen in individuals with diabetes in both the MESA (OR 1.81; CI 1.30–2.53) and the BDES (OR 1.16; CI 1.05–1.29). Phosphate was not associated with incident or change in retinopathy severity, nor any retinal caliber outcome. Conclusions Among community-living individuals with low prevalence of CKD, higher serum phosphate was associated with prevalent retinopathy in individuals with diabetes. Further longitudinal assessments in patients with diabetes necessitate further investigation.

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“…6 We also replicated results of the Beaver Dam Eye Study showing CRVE was related to older age in our T1D participants. 40 The reasons for these disparate relationships between CRAE and CRVE are not known and deserve further study.…”

Section: Discussionmentioning

confidence: 99%

Long-term changes in retinal vascular diameter and cognitive impairment in type 1 diabetes

Nunley

Metti

Klein

et al. 2018

Diabetes and Vascular Disease Research

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Objective: To assess associations between cognitive impairment and longitudinal changes in retinal microvasculature, over 18 years, in adults with type 1 diabetes. Research design and methods: Participants of the Pittsburgh Epidemiology of Diabetes Complications Study received ≥3 fundus photographs between baseline (1986)(1987)(1988) and time of cognitive assessment (2010)(2011)(2012)(2013)(2014)(2015): N = 119; 52% male; mean age and type 1 diabetes duration 43 and 34 years, respectively). Central retinal arteriolar equivalent and central retinal venular equivalent were estimated via computer-based methods; overall magnitude and speed of narrowing were quantified as cumulative average and slope, respectively. Median regression models estimated associations of central retinal arteriolar equivalent and central retinal venular equivalent measures with cognitive impairment status, adjusted for type 1 diabetes duration. Interactions with HbA1c, proliferative retinopathy and white matter hyperintensities were assessed. Results: Compared with participants without cognitive impairment, those with clinically relevant cognitive impairment experienced 1.8% greater and 31.1% faster central retinal arteriolar equivalent narrowing during prior years (t = −2.93, p = 0.004 and t = −3.97, p < 0.0001, respectively). Interactions with HbA1c, proliferative retinopathy and white matter hyperintensities were not significant. No associations were found between central retinal arteriolar equivalent at baseline, at time of cognitive testing, or any central retinal venular equivalent measures, and cognitive impairment. Conclusion: Long-term arterial retinal changes could indicate type 1 diabetes-related cognitive impairment. Studies examining longitudinal central retinal arteriolar equivalent changes as early biomarkers of cognitive impairment risk are warranted.

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Determinants of Retinal Venular Diameter: The Beaver Dam Eye Study

Cited by 54 publications

References 53 publications

Retinopathy and Progression of CKD

Retinopathy and Progression of CKD

Serum Phosphate and Retinal Microvascular Changes: The Multi-Ethnic Study of Atherosclerosis and the Beaver Dam Eye Study

Long-term changes in retinal vascular diameter and cognitive impairment in type 1 diabetes

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