Relationship of Blood Pressure to Retinal Vessel Diameter in Type 1 Diabetes Mellitus

Klein, Ronald; Myers, Chelsea E.; Klein, Barbara E. K.; Zinman, Bernard; Gardiner, Robert; Suissa, Samy; Sinaiko, Alan R.; Donnelly, Sandra; Goodyer, Paul; Strand, Trudy; Mauer, Michael

doi:10.1001/archophthalmol.2009.391

Cited by 14 publications

(13 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A similar result was reported in patients with type 1 diabetes aged 15 to 58 years (mean 31 years) from the Renin- Angiotensin System Study (RASS) during which mean arteriolar and venular calibers both increased over 5 years. 21 In contrast, among adults with type 1 and type 2 diabetes aged 40þ years from the Wisconsin Epidemiologic Study of Diabetic Retinopathy, mean arteriolar calibers narrowed slightly, while mean venular calibers widened with increasing age. 22 In older adults without diabetes (aged 45-64), however, both arteriolar and venular calibers narrow with age and are associated with hypertension and cardiovascular risk, likely related to increased vessel stiffness.…”

Section: Discussionmentioning

confidence: 98%

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

Liew

Benitez‐Aguirre

Craig

et al. 2017

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 98%

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

Liew

Benitez‐Aguirre

Craig

et al. 2017

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

show abstract

“…However, the antihypertensive treatment produced no statistically significant changes in retinal blood vessel caliber in these younger, normotensive, normoalbuminuric with type 1 diabetics in a randomized controlled trial. 79 …”

Section: Diabetic Retinopathymentioning

confidence: 99%

How does hypertension affect your eyes?

2011

View full text Add to dashboard Cite

Hypertension has profound effects on various parts of the eye. Classically, elevated blood pressure results in a series of retinal microvascular changes called hypertensive retinopathy, comprising of generalized and focal retinal arteriolar narrowing, arteriovenous nicking, retinal hemorrhages, microaneurysms and, in severe cases, optic disc and macular edema. Studies have shown that mild hypertensive retinopathy signs are common and seen in nearly 10% of the general adult non-diabetic population. Hypertensive retinopathy signs are associated with other indicators of end-organ damage (for example, left ventricular hypertrophy, renal impairment) and may be a risk marker of future clinical events, such as stroke, congestive heart failure and cardiovascular mortality. Furthermore, hypertension is one of the major risk factors for development and progression of diabetic retinopathy, and control of blood pressure has been shown in large clinical trials to prevent visual loss from diabetic retinopathy. In addition, several retinal diseases such as retinal vascular occlusion (artery and vein occlusion), retinal arteriolar emboli, macroaneurysm, ischemic optic neuropathy and age-related macular degeneration may also be related to hypertension; however, there is as yet no evidence that treatment of hypertension prevents vision loss from these conditions. In management of patients with hypertension, physicians should be aware of the full spectrum of the relationship of blood pressure and the eye.

show abstract

“…36,37 However, we found no significant association in this T1D cohort, similar to findings from another T1D study. 38 It is possible, for middle-aged or older people living with T1D since childhood, prolonged exposure to hyperglycaemia contributes more to the narrowing of retinal vessels than does high blood pressure. These individuals have been exposed to the deleterious effects of hyperglycaemia on the vasculature since childhood, as compared with a shorter window of exposure to high blood pressure (since middle age).…”

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

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Relationship of Blood Pressure to Retinal Vessel Diameter in Type 1 Diabetes Mellitus

Cited by 14 publications

References 35 publications

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

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

How does hypertension affect your eyes?

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

Contact Info

Product

Resources

About