PURPOSE: To examine the association of retinal vessel tortuosity with diabetic retinopathy and early nephropathy in type 1 diabetes. DESIGN: Cross-sectional. METHODS: A total of 1159 participants with type 1 diabetes aged 12 to 20 years, attending diabetes clinics in Children's Hospital at Westmead, Sydney, Australia between 1990 and 2002, were included. Retinal photography and clinical examinations were performed during the baseline visit to assess diabetic retinopathy and albumin excretion rate (AER). Retinal vessel tortuosity was measured from digitized retinal photographs using a semi-automated computer program by a single grader masked to participants' characteristics. Diabetic retinopathy was defined as ETDRS level ≥21 (mild nonproliferative retinopathy) and early kidney dysfunction was defined as AER ≥7.5 μg/min. RESULTS: Of 944 patients (81.4%), 85 (9.0%) had signs of retinopathy only, 250 (26.5%) had early kidney dysfunction only, and 85 (9.0%) had both retinopathy and early kidney dysfunction. In multivariate analysis, higher arteriolar tortuosity was associated with retinopathy (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.23-3.29, the highest quartile vs the remaining 3 quartiles), early kidney dysfunction (OR 1.56, 95% CI 1.06-2.28, per standard deviation [SD] increase), or coexistence of both complications (OR 1.96, 95% CI 1.21-3.24, the highest quartile vs the remaining 3 quartiles). CONCLUSIONS: Greater retinal arteriolar tortuosity was independently associated with retinopathy and early stage of nephropathy in type 1 diabetes. These findings may offer the potential of quantitative measurement of retinal vessel tortuosity for diabetic complication risk assessment.
PURPOSE: To examine the association of retinal vessel tortuosity with diabetic retinopathy and early nephropathy in type 1 diabetes. DESIGN: Cross-sectional. METHODS: A total of 1159 participants with type 1 diabetes aged 12 to 20 years, attending diabetes clinics in Children's Hospital at Westmead, Sydney, Australia between 1990 and 2002, were included. Retinal photography and clinical examinations were performed during the baseline visit to assess diabetic retinopathy and albumin excretion rate (AER). Retinal vessel tortuosity was measured from digitized retinal photographs using a semi-automated computer program by a single grader masked to participants' characteristics. Diabetic retinopathy was defined as ETDRS level ≥21 (mild nonproliferative retinopathy) and early kidney dysfunction was defined as AER ≥7.5 μg/min. RESULTS: Of 944 patients (81.4%), 85 (9.0%) had signs of retinopathy only, 250 (26.5%) had early kidney dysfunction only, and 85 (9.0%) had both retinopathy and early kidney dysfunction. In multivariate analysis, higher arteriolar tortuosity was associated with retinopathy (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.23-3.29, the highest quartile vs the remaining 3 quartiles), early kidney dysfunction (OR 1.56, 95% CI 1.06-2.28, per standard deviation [SD] increase), or coexistence of both complications (OR 1.96, 95% CI 1.21-3.24, the highest quartile vs the remaining 3 quartiles). CONCLUSIONS: Greater retinal arteriolar tortuosity was independently associated with retinopathy and early stage of nephropathy in type 1 diabetes. These findings may offer the potential of quantitative measurement of retinal vessel tortuosity for diabetic complication risk assessment.
Authors: Fang-Fei Wei; Zhen-Yu Zhang; Thibault Petit; Nicholas Cauwenberghs; Yu-Mei Gu; Lutgarde Thijs; Anke Raaijmakers; Lotte Jacobs; Wen-Yi Yang; Karel Allegaert; Tatiana Kuznetsova; Peter Verhamme; Harry A J Struijker-Boudier; Yan Li; Kei Asayama; Jan A Staessen Journal: Hypertens Res Date: 2016-07-07 Impact factor: 3.872
Authors: Ling-Jun Li; Kok Hian Tan; Izzuddin M Aris; Yap Seng Chong; Seang Mei Saw; Peter Gluckman; Jie Jin Wang; Tien Yin Wong Journal: Diabetologia Date: 2017-09-22 Impact factor: 10.122
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
Authors: Ronald Klein; Kristine E Lee; Lorraine Danforth; Michael Y Tsai; Ronald E Gangnon; Stacy E Meuer; Tien Y Wong; Carol Y Cheung; Barbara E K Klein Journal: Ophthalmology Date: 2018-05-18 Impact factor: 12.079
Authors: Alicia J Jenkins; Mugdha V Joglekar; Anandwardhan A Hardikar; Anthony C Keech; David N O'Neal; Andrzej S Januszewski Journal: Rev Diabet Stud Date: 2015-08-10