Ronald Klein1, Barbara E K Klein, Scot E Moss, Tien Y Wong. 1. Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53726-2336, USA. Kleinr@epi.ophth.wisc.edu
Abstract
OBJECTIVE: To describe the relationship of retinal arteriolar and venular calibers to the long-term incidence of microvascular and macrovascular complications in people with type 2 diabetes. DESIGN: Population-based prospective study. PARTICIPANTS: One thousand three hundred seventy persons diagnosed to have diabetes at > or =30 years of age in south central Wisconsin participated in the baseline examination from 1980 to 1982, 987 in the 4-year follow-up, and 533 in the 10-year follow-up. METHODS: Computer-assisted grading was used to determine the average caliber of retinal arterioles (central retinal arteriolar equivalent [CRAE]) and retinal venules (central retinal venular equivalent [CRVE]) at all examinations. MAIN OUTCOME MEASURES: Incidence and progression of diabetic retinopathy; incidence of proliferative diabetic retinopathy and macular edema; incidence of nephropathy, neuropathy, and lower extremity amputation; and ischemic heart disease, stroke, and overall mortality. RESULTS: While adjusting for other factors, smaller CRAE was associated with the 14-year cumulative incidence of lower extremity amputation (odds ratio [OR], first vs. second to fourth quartiles, 2.20; 95% confidence interval [CI], 1.14-4.24; P = 0.02), 22-year all-cause mortality (hazard ratio [HR], 1.18; 95% CI, 1.02-1.38; P = 0.03), and 22-year stroke mortality (HR, 1.47; 95% CI, 1.04-2.07; P = 0.03) but not with the other end points. Larger CRVE was associated with the 14-year incidence of diabetic nephropathy (OR, fourth vs. first to third quartiles, 2.08; 95% CI, 1.47-2.94; P<0.001) and 22-year stroke mortality (HR, 1.71; 95% CI, 1.20-2.44; P = 0.003) but with none of the other end points. CONCLUSIONS: Retinal vessel caliber is independently associated with risk of incident nephropathy, lower extremity amputation, and stroke mortality in persons with type 2 diabetes. Measurement of retinal vessel caliber from photographs may provide additional information for the prediction of these events.
OBJECTIVE: To describe the relationship of retinal arteriolar and venular calibers to the long-term incidence of microvascular and macrovascular complications in people with type 2 diabetes. DESIGN: Population-based prospective study. PARTICIPANTS: One thousand three hundred seventy persons diagnosed to have diabetes at > or =30 years of age in south central Wisconsin participated in the baseline examination from 1980 to 1982, 987 in the 4-year follow-up, and 533 in the 10-year follow-up. METHODS: Computer-assisted grading was used to determine the average caliber of retinal arterioles (central retinal arteriolar equivalent [CRAE]) and retinal venules (central retinal venular equivalent [CRVE]) at all examinations. MAIN OUTCOME MEASURES: Incidence and progression of diabetic retinopathy; incidence of proliferative diabetic retinopathy and macular edema; incidence of nephropathy, neuropathy, and lower extremity amputation; and ischemic heart disease, stroke, and overall mortality. RESULTS: While adjusting for other factors, smaller CRAE was associated with the 14-year cumulative incidence of lower extremity amputation (odds ratio [OR], first vs. second to fourth quartiles, 2.20; 95% confidence interval [CI], 1.14-4.24; P = 0.02), 22-year all-cause mortality (hazard ratio [HR], 1.18; 95% CI, 1.02-1.38; P = 0.03), and 22-year stroke mortality (HR, 1.47; 95% CI, 1.04-2.07; P = 0.03) but not with the other end points. Larger CRVE was associated with the 14-year incidence of diabetic nephropathy (OR, fourth vs. first to third quartiles, 2.08; 95% CI, 1.47-2.94; P<0.001) and 22-year stroke mortality (HR, 1.71; 95% CI, 1.20-2.44; P = 0.003) but with none of the other end points. CONCLUSIONS: Retinal vessel caliber is independently associated with risk of incident nephropathy, lower extremity amputation, and stroke mortality in persons with type 2 diabetes. Measurement of retinal vessel caliber from photographs may provide additional information for the prediction of these events.
Authors: Rupal Mehta; Alexander Hodakowski; Xuan Cai; Kris E Lee; Bryan R Kestenbaum; Ian H de Boer; Amani Fawzi; Tien Yin Wong; Joachim Ix; Barbara Klein; Ronald Klein; Tamara Isakova Journal: Ophthalmic Epidemiol Date: 2017-04-12 Impact factor: 1.648
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Authors: R Klein; M D Knudtson; B E K Klein; B Zinman; R Gardiner; S Suissa; A R Sinaiko; S M Donnelly; P Goodyer; T Strand; M Mauer Journal: Diabetologia Date: 2010-05-01 Impact factor: 10.122
Authors: Rupal Mehta; Gui Shuang Ying; Samuel Houston; Tamara Isakova; Lisa Nessel; Akinlolu Ojo; Alan Go; Jim Lash; John Kusek; Juan Grunwald; Myles Wolf Journal: Nephrol Dial Transplant Date: 2015-04-24 Impact factor: 5.992
Authors: M L Rasmussen; R Broe; U Frydkjaer-Olsen; B S Olsen; H B Mortensen; T Peto; J Grauslund Journal: Graefes Arch Clin Exp Ophthalmol Date: 2016-08-12 Impact factor: 3.117