Purchase this article with an account.
J. J. Wang, E. Rochtchina, S. Kaushik, A. Kifley, T. Y. Wong, P. Mitchell, Blue Mountains Eye Study; Long-Term Incidence of Isolated Retinopathy Lesions in Older Persons Without Diabetes: The Blue Mountains Eye Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1236.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To assess 10-year incidence of isolated retinopathy lesions and associated risk factors in persons without diabetes.
Of 3654 Blue Mountains Eye Study baseline participants aged 49+ years, 2335 (75% of 3111 survivors) were followed after 5 years (1997-9), and 1935 (75.0% of 2581 survivors) after 10 years (2002-4). Retinopathy lesions (microaneurysms, hemorrhages, hard or soft exudates) in persons without diabetes were assessed from retinal photographs. Mild retinopathy was defined if a single microaneurysm/ hemorrhage was present, and moderate if ≥2 microaneurysms/ hemorrhages or any hard/ soft exudates were present. Stage I hypertension was defined as systolic blood pressure (BP) ≥140 but <160 mmHg, diastolic BP ≥90 but <100 mmHg, and stage II was defined as systolic BP ≥160mmHg, diastolic BP ≥100 mmHg or by current use of antihypertensive medications. Obesity was defined as body mass index >30.
After excluding participants with retinopathy lesions at baseline, and those with diabetes or ungradeable retinal photos at any visit, 1678 participants were at risk of incident retinopathy who were followed-up at least once. At the 10-year exam, cumulative incidence of retinopathy was 16.0% (n=269). Of these, 184 had mild and 76 moderate retinopathy (9 were undetermined). No significant associations were found for incident mild retinopathy. Baseline stage I or II hypertension (hazard ratio, HR 1.85, 95% confidence interval, CI 1.02-3.37) and obesity (HR 2.19, 95% CI 1.28-3.75) were significantly associated with incident moderate retinopathy, after adjusting for age and sex.Of 291 persons with retinopathy but no diabetes at baseline, 121 (72.5%) had died, 46 (27.5%) were lost to follow-up, 7 developed diabetes and 2 retinal vein occlusion. Of the remaining 115 persons, retinopathy lesions completely disappeared in 74 (64.3%). No significant associations were found for retinopathy disappearance.At the 10-year exam, cumulative incident rates of diabetes (6.1% vs 8.0%, p=0.4) and stage II hypertension (46.3% vs 43.1%, p=0.6) were similar in persons with vs those without retinopathy at baseline.
Isolated retinopathy lesions in older people without diabetes are common but transient. No increased long-term risk of diabetes and hypertension was evident in generally healthy, older persons with retinopathy lesions.
This PDF is available to Subscribers Only