Progressive Retinal Vasodilation in Patients With Type 1 Diabetes: A Longitudinal Study of Retinal Vascular Geometry

Abstract

Citation: Liew G, Benitez-Aguirre P, Craig ME, et al. .3) mmol/mol]) over three visits, with a mean follow-up of 2.6 years. Retinal vascular geometry was measured using a standardized computer-assisted protocol from retinal photographs at each visit. Multivariable linear mixed-models and logistic regression were used to examine predictors of RVG and diabetic retinopathy.RESULTS. During follow-up, mean arteriolar caliber, venular caliber, and venular tortuosity increased, from 156.0 (SD, 14.5) to 164.9 (14.0) lm, 215.9 (22.5) to 230.3 (20.6) lm, and 1.096 (0.014) to 1.099 (0.016), respectively (all P < 0.005). Other RVG measurements (fractal dimension, branching angle, length to diameter ratio) remained stable. Higher than baseline HbA1c and longer diabetes duration were associated with greater venular vasodilation. Retinopathy developed at any time-point in 24% of subjects, and the highest tertile arteriolar fractal dimension was associated with cumulative incidence of retinopathy (multivariable odds ratio 3.2, 95% confidence interval 1.0-9.6; P ¼ 0.04).CONCLUSIONS. Higher HbA1c and longer diabetes duration in early adolescence predicts greater venular vasodilation over time. Arteriolar fractal dimension predicts subsequent retinopathy development, suggesting value as a potential biomarker for diabetic complications.

Hemoglobin A1c and retinal arteriolar narrowing in children with type 1 diabetes: the diagnostics of early atherosclerosis risk in kids study

“…The fact that there is no association of CRVE and diabetes parameters in our patients seems to indicate that diabetes‐induced venular widening may occur later in life. In contrast to our findings, Liew et al recently found increasing CRVE in late adolescent diabetes patients . This might be explained by the slightly higher age of their subjects.…”

“…Several studies show that changes in macrovascular and functional parameters correlate with quality of diabetes control and conventional cardiovascular risk factors . There is growing evidence that also microvascular changes can be demonstrated in children and adolescents …”

Imaging the eye and its relevance to diabetes care

“…A study measuring length-to-diameter ratio and simple tortuosity in type 1 diabetes found lower arteriolar length-to-diameter ratio and greater simple tortuosity predicted incident DR over a median follow-up time of 3.8 years 56 , with these findings confirmed in another study 57 . In the same cohort of type 1 diabetes patients, longitudinal changes of retinal vessel geometry were examined, they found that retinal vessels dilated and became more tortuous over 2.6year follow up 58 . The Singapore Malay Eye Study found that wider CRAE was associated with the incidence of referable DR at 6 years, as were changes in other geometric parameters.…”

Predicting High Coronary Artery Calcium Score From Retinal Fundus Images With Deep Learning Algorithms

“…With high-resolution retinal fundus images, geometric factors of retinal vasculature such as diameter, curvature tortuosity, and branching angles can be analyzed to help assess coronary artery diseases, 1 CVDs, 2,3 or diabetes mellitus. 4 The diameters of the retinal vessels have also been shown to be associated with cognitive ability 5,6 and dementia 7 in an older population.…”