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H. Lai, I. Lueng, S. Ren, M. Tso, S. Lai; Retinal Vascular Abnormalities in the African American Cocaine Users . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3050.
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Cocaine use has been implicated in multiple cardiovascular complications. Nevertheless, the ocular complications of cocaine use have not been thoroughly investigated. The purpose of this study is to assess the impact of cocaine use on retinal vascular changes.
Seventy–five African Americans aged between 31 and 49 years without hypertension and clinical heart diseases were recruited in this study. Among these 75 study subjects, 25 (33.3%) were females. Cocaine use was based on self–reported data. HIV status was determined by ELISA and confirmed by Western blot test. General eye examinations were performed and digital fundus images were captured concentric to the optic nerve head using a 30–degree fundus camera. An optometrist, who was masked from information of cocaine use and HIV status of the subjects, evaluated the retinal vascular changes. The retinal arterial branching was scored according to the severity of the branching angle in the fundus images. Severe branching angle was defined as branching angle greater than 90 degrees. Statistical analysis was performed using Generalized Estimating Equation (GEE) regression model.
Data from 150 eyes of 75 subjects were included in the analysis. Approximately half of the study subjects (48.0%) were HIV positive cocaine users; 22 (29.3%) were HIV negative cocaine users; 13 (17.3%) were non–cocaine users but HIV positive. Univariate analysis indicated that cocaine use was significantly associated with severe arterial branching (OR=2.44, 95% CI: 1.01–5.9). A longer duration of cocaine use was also significantly associated with the presence of retinal haemorrhage (OR=1.13, 95% CI: 1.05–1.24). Multivariate analysis showed that after the adjustment for age, gender and total cholesterol level, cocaine users were 3 times more likely to have severe arterial branching (OR=3.06, 95% CI: 1.26–7.40). A dose–response relationship between a longer duration of cocaine use and presence of retinal haemorrhage was also observed (OR=1.14, 95% CI: 1.02–1.27). HIV infection was not found to be significantly associated with the above two retinal vascular changes in this study population.
In this study population of normotensive middle–age individuals, cocaine use may have an impact on retinal vascular changes marked by arterial branching and retinal haemorrhage.
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