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S. Cugati, L. Cikamatana, J.J. Wang, A. Kifley, P. Mitchell, Blue Mountains Eye Study; Five Year Incidence of Retinopathy in Persons Without Diabetes: The Blue Mountains Eye Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1161.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: We previously reported a 9.8% prevalence of retinopathy lesions among subjects without diabetes. This report aims to assess the 5–year incidence of retinopathy in the same older non–diabetic population. Methods: The BMES examined 3654 residents aged 49+ years (82.4% response) during1992–4 and after 5 years, re–examined 2335 participants (75.1% of survivors). Retinopathy lesions (microaneurysms, hemorrhages, hard exudates, cotton wool spots or intra retinal microvascular abnormalities) were assessed from stereoscopic retinal photographs in persons without diabetes, defined from history and fasting glucose tests. Incident retinopathy was indicated by three levels: microaneurysms only, haemorrhages only or two or more types of lesions and the presence of cotton wool spots, hard exudates and intra retinal microvascular abnormalities in either eye. Participants were classified as having either normal BP (systolic BP [SBP] <120 mm Hg and/or diastolic BP [DBP] <80 mm Hg), prehypertension (SBP 120–139 mm Hg and/or DBP 80–89 mm Hg), stage 1 hypertension (SBP 140–159 mm Hg and/or DBP 90–99 mm Hg) or stage 2 hypertension (SBP ≥160 mm Hg and/or DBP ≥100 mm Hg). Hypertriglyceridemia was defined as serum triglycerides ≥ 2.0 mmol/L. Results: Of those attending 5–year exams, we excluded 261 persons with diabetes, 228 persons who had retinopathy lesions at baseline and 76 with ungradable photos at either exam. This left 1742 persons at risk of incident retinopathy. The cumulative 5–year incidence of any retinopathy lesion was 10.6% (95% confidence interval, CI, 9.1–12.0%). Incidence increased with age (p for trend <0.01). New isolated microaneurysms were found in 3.6%, hemorrhages were found in 5.5%, and multiple lesions were present in 1.6%. After adjusting for age and sex, a significant association between a more severe level of incident retinopathy and hypertriglyceridemia (RR 1.39, CI 1.14–1.70) was observed. The trend suggested an increased incidence of retinopathy with increasing BP but did not reach statistical significance (normal BP 7.9%, prehypertension 9.2%, stage 1 hypertension 10.1%, and stage 2 hypertension 12.0%, p for trend< 0.08). Conclusions: Findings from this older population confirm that retinopathy lesions develop relatively frequently in older persons without diabetes.Age, blood pressure, blood lipid levels and other unknown non–hypertensive factors appear to be involved in the development of these lesions.
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