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Dragana Drobnjak, Nina Veiby, Torben Jørgensen, Line Kessel, Michael Larsen, Inger Munch; Vessel diameter and retinopathy in the Inter99 Eye Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5327.
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To examine the relationship between retinal vessel diameters and retinal microangiopathy in healthy and diabetic subjects.
The study population of the Inter99 study comprised an age- and sex-stratified sample of 13.016 participants residing in 11 suburban municipalities of the south-western part of Copenhagen Country. Of 6784 subjects aged 30-60 years who participated in the main study, a subgroup of 970 subjects participated in the eye study. Digital fundus photos were taken at the baseline examination. Subjects with ungradeable images were excluded. 935 participants were graded for retinopathy according to the ETDRS standard. Vessel diameters were expressed as central retinal artery equivalent diameter (CRAE), and central retinal vein equivalent diameter (CRVE). Multivariate analyses was used to compare data sets.
CRAE decreased with increasing systolic blood pressure (p<0.0001) and with increasing age (p<0.001). CRAE was increased in subjects with known diabetes mellitus. CRAE increased with 4.2 µm (CI95%:1.1-7.4, p=0.0079) in subjects with retinopathy compared to subjects without retinopathy adjusting for age, sex, glucose regulation and systolic blood pressure in all subjects (n=935). CRVE decreased with increasing age (p=0.0365). CRVE increased with 4.57 µm (CI95%: 0.19-8.9, p=0.041) in subjects with retinopathy compared to subjects without retinopathy adjusting for age, sex, glucose regulation and systolic blood pressure in all subjects. In participants without diabetes mellitus CRAE and CRVE increased with 1 µm in subjects with retinopathy compared to subjects without retinopathy, but not significantly. In participants with diabetes mellitus, CRAE increased significantly with 6.5 µm (CI95% 1.17-11.9, p=0.017) in subjects with retinopathy compared to subjects without retinopathy. In participants with diabetes mellitus CRVE increased significantly with 7.8 µm (CI95% 0.33-15.3, p=0.041) in subjects with retinopathy compared to subjects without retinopathy.
Wider retinal arterial and vein diameters were significantly associated with retinopathy in subjects with diabetes mellitus. Development of better and newer approaches to retinal vascular imaging is needed to raise the power of detection and the accuracy of quantification of retinal microvascular changes. This development may help to understand the pathology and association between elements leading to retinopathy progression.
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