Dyslipidaemia and microvascular disease in the retina

Abstract

Purpose There are few data on the effect of serum lipids on microvascular disease. This study assessed the relationships between serum lipid levels and microvascular disease, as seen in the retina, among participants who attended a population-based study in Australia (n ¼ 3654, aged 49 þ years). Methods Diameters of retinal arterioles and venules were measured from digitised photographs of each participant to obtain an estimate of generalised arteriolar narrowing. Focal arteriolar narrowing, arteriovenous nicking, and retinopathy lesions (microaneurysms, haemorrhages, hard/soft exudates) were graded using a standard protocol. Fasting blood tests were performed in 89% of subjects. Adjusted means were calculated using general linear models. Logistic regression models were used to determine the odds ratios for retinal microvascular signs. Results After controlling for age, sex, body mass index, smoking, and mean arterial blood pressure, elevated high-density lipoprotein cholesterol was associated with narrower retinal arterioles (P trend ¼ 0.002) and venules (P trend ¼ 0.03) and with increased odds of generalised arteriolar narrowing (odds ratio 1.6, 95% confidence interval 1.1-2.2 for the highest vs the lowest quintile of high-density lipoprotein cholesterol). Serum triglyceride had a U-shaped relationship with venular diameter (P trend ¼ 0.003). We found no consistent pattern of association between serum total cholesterol or low-density lipoprotein cholesterol and any retinal microvascular signs. Conclusions These findings suggest that microvascular disease in the retina may result from processes distinct from dyslipidaemia.

Prevalence and associated factors of diabetic retinopathy. The Beijing Eye Study 2006

“…It confirms a recent evaluation from the Blue Mountains Eye Study [36]. In the latter investigation, retinal microvascular signs were significantly associated with elevated high-density lipoprotein cholesterol.…”

Body fat distribution, metabolic and inflammatory markers and retinal microvasculature in school-age children. The Generation R Study

“…Two studies among adults found that lower high-density lipoprotein cholesterol levels, but not total-and low-density lipoprotein cholesterol and triglycerides levels, were associated with narrower retinal arteriolar caliber. 37,39 Inconsistent results for the associations of diabetes and impaired fasting glucose with retinal vessel calibers have been reported among adults. 40,41 A study among 573 children aged 11 years showed that higher triglyceride and glucose levels were associated with wider retinal venular caliber.…”

Retinal vessel structure measurement using spectral-domain optical coherence tomography

“…[15][16][17][18][19][20] Therefore, the assessment of vessel diameters is highly desirable. OCT technologies have greatly improved; however, future OCT technologies such as the combination of adaptive optics and OCT will have a higher resolution that will enable observation at the cellular level in the near future.…”