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M. Okada, T. Y. Wong, R. Kawasaki, N. Baharuddin, D. Colville, R. R. Buchanan, J. Savige; Retinal Venular Caliber is Increased in Patients With Autoimmune Rheumatic Diseases. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3792.
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Patients with autoimmune rheumatic disease have a high vascular disease burden. Evidence suggests that systemic inflammation, a risk factor for cardiovascular disease, is associated with changes in the retinal vasculature, with wider retinal venular caliber in particular. The aim of this study was to determine the relationship between retinal vascular caliber and autoimmune rheumatic disease.
A case-control study was conducted involving 124 patients with autoimmune rheumatic disease and 124 age-and-gender-matched controls, recruited from the Northern Hospital in metropolitan Melbourne, Australia. Rheumatic disease was diagnosed by a rheumatologist using the American College of Rheumatology criteria. Participants completed a structured questionnaire and had fundus photographs taken of both eyes. Retinal vascular caliber was measured using a computer-based technique by certified graders masked to patient characteristics and disease status. Summary indices representing estimated average diameter of central retinal artery and vein (Central Retinal Artery Equivalent [CRAE] and Central Retinal Venular Equivalent [CRVE]) were calculated. Multiple regression analyses were performed to estimate the difference in retinal vessel caliber.
Each group comprised 70 males (28%) and 178 females (72%), with a mean age of 60 years (range 19 to 88). Diagnoses were rheumatoid arthritis (76, 61%), systemic lupus erythematosus (17, 14%), psoriatic arthritis (11, 9%) and others (20, 16%). CRVE was wider in patients (222.55 µm ± 26.42) compared with controls (217.31µm ± 25.28). After adjustment for age, gender, body mass index, hypertension, diabetes, smoking, dyslipidaemia, renal impairment and anaemia, CRVE was significantly wider in patients with rheumatic disease (+9.21µm, Confidence Interval: 2.28-16.14 p=0.009) than controls. There were no significant associations between retinal arteriolar caliber and rheumatic disease.
Patients with autoimmune rheumatic disease were more likely to have increased retinal venular caliber. Further studies may determine whether retinal vascular caliber can represent an additional tool for cardiovascular risk stratification in autoimmune rheumatic disease.
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