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G. Liew, S. Kaushik, E. Rochtchina, P. Mitchell, J.J. Wang, Blue Mountains Eye Study; Retinal Vessel Wall Signs and 10–Year Incident Age–Related Maculopathy: The Blue Mountains Eye Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2204.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the longitudinal association between retinal vessel signs and long–term risk of age related maculopathy (ARM).
3654 Blue Mountains Eye Study participants aged 49+ years were examined during 1992–4; 2335 (75% of survivors) were re–examined after 5–years and 1952 (76% of survivors) after 10–years. Baseline focal arteriolar narrowing and arteriovenous (AV) nicking was assessed and vessel calibers were measured. Photographs of participants with ARM lesions at any of the exams were re–graded by the same graders using a side–by–side method. Incident late ARM was defined if neovascular ARM or geographic atrophy was detected at either follow–up examination in persons free of these lesions in both eyes at baseline. Incident early ARM was defined if early ARM (soft indistinct or reticular drusen or combined soft distinct drusen and retinal pigment abnormality) was present in persons free of early and late ARM at baseline. Eye–specific data were analyzed using generalized estimating equation models that incorporated information from both follow–up time points and adjusted for age, sex, smoking and blood pressure and correlation between eyes.
Over a 10–year period, incident late ARM developed in 106 (2.2%) of 4745 eyes at risk of late ARM. Eyes with mild (2.7%) or moderate to severe (4.6 %) AV nicking were more likely to develop late ARM compared to eyes without this sign (1.5%), adjusted OR 1.4, CI 0.8–2.4 for mild and OR 2.6, CI 1.2–5.5 for moderate to severe AV nicking. Eyes with focal narrowing were also more likely to develop late ARM (7.6% vs 1.8%), adjusted OR 2.2, CI 1.1–4.1. Incident early ARM developed in 398 (8.9%) of 4490 eyes at risk of early ARM. Presence of moderate to severe AV nicking was associated with an increased risk of early ARM (13.6% vs 8.2%, OR 1.5, CI 1.0–2.3) but focal arteriolar narrowing was not associated with incident early ARM (13.8% vs 8.5%, OR 1.2, CI 0.7–1.9). In subgroup analyses, moderate to severe AV nicking was associated with incident late ARM only in persons without hypertension (OR 4.6, CI 1.5–14.2). Focal arteriolar narrowing was associated with incident late ARM only in persons with hypertension (OR 3.0, CI 1.3–6.7). Neither venule–adjusted arteriolar caliber nor arteriole–adjusted venular caliber was significantly associated with early or late ARM incidence.
This study confirms our previous observation that structural retinal arteriolar changes may be associated with ARM development.
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