June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Aspirin, statins and central retinal venular diameter in persons with and without diabetes
Author Affiliations & Notes
  • Christine A Kiire
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Kristine E Lee
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Barbara E K Klein
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Ronald Klein
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Footnotes
    Commercial Relationships   Christine Kiire, None; Kristine Lee, None; Barbara Klein, None; Ronald Klein, None
  • Footnotes
    Support  Supported by the National Institutes of Health, Bethesda, Maryland (grant no. EY006594 [RK, BEKK]) and P30EY016665 [Research Vision Core Grant]), and, in part, Research to Prevent Blindness, New York, New York (Senior Scientific Investigator awards [RK, BEKK]). The National Eye Institute, Bethesda, Maryland, provided funding for the entire study, including collection and analyses of data; Research to Prevent Blindness provided further support for data analyses. CAK is a US-UK Fulbright Scholar supported by Fight for Sight UK.
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2891. doi:
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    • Get Citation

      Christine A Kiire, Kristine E Lee, Barbara E K Klein, Ronald Klein; Aspirin, statins and central retinal venular diameter in persons with and without diabetes. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2891.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Widened retinal venular diameter, as measured by increased central retinal venular equivalent (CRVE), is associated with systemic inflammation. Evidence suggests that aspirin has an altered anti-inflammatory profile in persons with type 2 diabetes (T2D) compared to those without diabetes. This might contribute to the less-than-expected cardiovascular benefits of taking aspirin seen in those with T2D. Statins have been shown to improve platelet sensitivity to aspirin in vitro, and to improve endothelial function and reduce inflammation. We set out to investigate the effect of regular aspirin, statins, or a combination of aspirin & statins on CRVE in persons with and without diabetes (mainly T2D) in the Beaver Dam Eye Study, a longitudinal cohort study.

Methods : Cross-sectional analysis of data from 2003-2005 and 2008-2010. Participants were divided into 4 groups by their history of use of statins and aspirin: A=no aspirin & no statin; B=aspirin & no statin; C=statin & no aspirin; D=aspirin & statin. CRVE(OD) was measured from fundus photographs using standardized protocols. Those with signs of previous retinal laser photocoaguation were excluded. The effect of age, sex, BMI, systolic BP, smoking status, HbA1c, aspirin use, statin use, vasodilator use, and photo quality (focus), on CRVE was analyzed in those with and without diabetes. These variables were only included in the models if significantly associated with CRVE. Generalized estimating equations approaches were used to account for multiple visits for a person.

Results : Among those with diabetes (>70% of whom had no diabetic retinopathy) there was a significant difference between the groups (p=0.04). Group B was significantly associated with a wider CRVE than Group A, after adjusting for age, systolic BP, smoking status, sex, BMI and focus (p=0.004). Statin use, alone or with aspirin, was not significantly associated with CRVE (Group C vs A, Group D vs A). In those without diabetes, there was no significant difference in CRVE among Groups B-D vs Group A.

Conclusions : Regular aspirin use is associated with a wider CRVE in those with diabetes in this population. This association is not seen in those without diabetes, or in those with diabetes who are taking both aspirin and a statin. Further exploring the possibility of confounding by indication, as well as potential biological mechanisms to explain this finding, may be of value in future analyses.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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