April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Retinal Vessel Tortuosity and Incidence of Diabetic Retinopathy in Type 1 Diabetes
M. B. Sasongko; P. B. Aguirre; J. J. Wang; K. Donaghue; N. Cheung; A. Jenkins; T. Y. Wong
Author Affiliations & Notes
  • M. B. Sasongko
    Ophthalmology, CERA, University of Melbourne, Melbourne, Australia
    Dept. of Ophthalmology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
  • P. B. Aguirre
    Children Hospital at Westmead, University of Sydney, Sydney, Australia
  • J. J. Wang
    Ophthalmology, CERA, University of Melbourne, Melbourne, Australia
    Centre for Vision Research, University of Sydney, Sydney, Australia
  • K. Donaghue
    Children Hospital at Westmead, University of Sydney, Sydney, Australia
  • N. Cheung
    Ophthalmology, CERA, University of Melbourne, Melbourne, Australia
  • A. Jenkins
    Dept. of Medicine, University of Melbourne, Melbourne, Australia
  • T. Y. Wong
    Ophthalmology, CERA, University of Melbourne, Melbourne, Australia
    Singapore Eye Research Institute, National University of Singapore, Singapore, Singapore
  • Footnotes
    Commercial Relationships  M.B. Sasongko, None; P.B. Aguirre, None; J.J. Wang, None; K. Donaghue, None; N. Cheung, None; A. Jenkins, None; T.Y. Wong, Patent, P.
  • Footnotes
    Support  National Health and Medical Research Council (NHMRC), 475605 & the Juvenile Diabetes Research Foundation (JDRF), 5-2008-274
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 1240. doi:
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      M. B. Sasongko, P. B. Aguirre, J. J. Wang, K. Donaghue, N. Cheung, A. Jenkins, T. Y. Wong; Retinal Vessel Tortuosity and Incidence of Diabetic Retinopathy in Type 1 Diabetes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1240.

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Abstract

Purpose: : Retinal vascular caliber changes have been associated with microvascular complications in type 1 diabetes (T1D). In this study, we aimed to examine the prospective association of retinal vessel tortuosity and other vascular morphological parameters with incident diabetic retinopathy (DR) in young people with T1D.

Methods: : A cohort of 510 initially retinopathy-free patients with T1D, aged 12 to 20 years, were enrolled during 1990 to 2002 from a tertiary hospital in Sydney. Participants had 7-field stereoscopic retinal photographs of both eyes taken at baseline and follow-up. Incident DR was graded according to the modified Airlie House classification from follow-up photographs. Parameters of retinal vascular morphology including branching angle, tortuosity, optimality deviation, and length to diameter ratio (LDR) were quantitatively measured from baseline photographs using a computer-based program following a standardized protocol. Associations between these retinal vascular parameters with incident DR were assessed using multiple logistic regression, adjusted for relevant covariates.

Results: : Over 5 years of follow-up, 214 (41.9%) patients developed DR. Those who developed DR were generally older, had longer diabetes duration, and higher HbA1c at baseline. After adjusting for age and sex, each standard deviation (SD) increase of both arteriolar and venular tortuosity was associated with increased risk of developing DR within 5 years of follow-up (Odds Ratio 2.90 [95% CI 1.63 - 5.14] and 1.82 [1.11 - 2.96] respectively). Branching angle, optimality deviation, and LDR were not found to be associated with incident DR. Association of vessel tortuosity persisted after adjusting for BMI, cholesterol level, blood pressure, diabetes duration, HbA1c, vessel caliber, and other diabetic complications.

Conclusions: : Retinal arteriolar and venular tortuosity was associated with the development of DR in T1D, independent of standard retinopathy risk factors. This suggests that abnormalities of retinal vascular morphology may represent early microvascular changes in the development of DR.

Keywords: diabetic retinopathy • imaging/image analysis: clinical • clinical (human) or epidemiologic studies: prevalence/incidence 
© 2010, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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