The Relationship of Retinal Vascular Caliber and Glaucoma: The Singapore Malay Eye Study

Abstract

Purpose: : To examine the relationship between retinal vascular caliber and glaucoma in an elderly Asian population.

Methods: : This was a population based, cross-sectional study of 3,019 Asian Malays adults aged 40-80 years residing in Singapore. All participants had retinal photographs taken of both eyes after papillary dilation. Retinal vascular caliber was measured using a computer-based technique following a standardized protocol. Glaucoma was diagnosed based on the International Society of Geographic and Epidemiological Ophthalmology (ISGEO) classification and included people with glaucomatous optic neuropathy and compatible visual field loss.

Results: : There were 127 (4.2%) participants with glaucoma. The mean retinal arteriolar calibers were narrower in people with (136.4µm) than those without (139.7µm) glaucoma (p=0.02). A similar relationship was seen for retinal venular caliber (209.2µm vs 219.7µm, p<0.001). After adjusting for age, gender, smoking, and other vascular risk factors, both narrower retinal arteriolar and venular caliber were associated with increased odds of glaucoma (odds ratio [OR] 1.30; 95% confidence interval [CI]: 1.06, 1.59 and OR 1.61; 95% CI: 1.33, 1.96, comparing a standard deviation decrease in arteriolar and venular caliber, respectively). A vertical cup to disc ratio ≥ 0.5 was also associated with narrower retinal arteriolar and venular caliber (OR 1.18; 95% CI: 1.07, 1.30 and OR 1.29; 95% CI: 1.18, 1.42, respectively). Retinal arteriolar or venular calibers were not associated with intraocular pressure.

Conclusions: : Persons with glaucoma are more likely to have narrower retinal vessels. These findings support the association of retinal microvascular changes with the glaucomatous optic neuropathy.

Keywords: clinical (human) or epidemiologic studies: risk factor assessment