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B. Taylor, J. Wang, E. Rochtchina, P. Mitchell, Blue Mountains Eye Study; Does Retinal Arteriolar Narrowing Precede the Long-Term Development of Open-Angle Glaucoma: Blue Mountains Eye Study Findings. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3085. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To assess whether baseline retinal arteriolar narrowing predicts incident open angle glaucoma in an older population.
The Blue Mountains Eye Study (BMES) examined 3,654 participants aged 49+ years at baseline (1992-4). Retinal photographs were digitised and retinal arteriolar and venular diameters measured. Open angle glaucoma (OAG) was diagnosed from matching visual field defects and optic disc cupping, without reference to intra-ocular pressure (IOP) level. Associations between incident OAG and arteriolar or venular diameter were assessed after adjusting for baseline age, gender, IOP, use of glaucoma medications, vertical disc diameter, cup-to-disc ratio and baseline disc haemorrhage. Vessel diameter was analysed continuously and by tertile.
After excluding subjects with glaucoma or optic disc abnormalities at baseline or those with incomplete data, 2328 participants seen at the 5- and/or 10-year visits were considered at risk of incident OAG. This developed in 99 eyes of 78 participants (3.4%), at either the 5- or 10-year follow-up exam. After adjusting for age and sex, narrower baseline arteriolar and venular diameter was associated with an increased risk of incident OAG (narrowest vs widest tertile, odds ratio, OR 2.32, 95% confidence interval, CI, 1.28- 4.20, p for trend 0.004 for arterioles and OR 1.76, CI 1.01- 3.05, p for trend 0.04 for venules). Each standard deviation (SD) decrease in vessel diameter was associated with an increased risk of incident OAG (OR 1.36 CI 1.07- 1.73 for arterioles and OR 1.28 CI 1.07- 1.73 for venules). After further adjusting for IOP, use of glaucoma medications, vertical disc diameter, cup-to-disc ratio and baseline disc haemorrhage, the associations with arteriolar narrowing remained but became borderline non-significant (OR 1.86, CI 1.00- 3.61, p for trend 0.057 for the lowest vs highest tertile, and OR 1.24, CI 0.94- 1.65 per SD decrease). The association with narrowed venular diameter was no longer present.
These findings suggest that retinal arteriolar narrowing may precede the development of OAG. This adds to previously reported BMES data which demonstrated a strong cross-sectional association between OAG and retinal arteriolar narrowing.
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