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M.K. Ikram, J.R. Vingerling, A. Hofman, M.M. B. Breteler, P.T. V. M. de Jong; Retinal Vessel Diameters and All–Cause Mortality: The Rotterdam Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1163.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To examine whether smaller retinal arteriolar or larger venular diameters predicted 10–year all–cause mortality in the prospective population–based Rotterdam Study. Methods: At baseline (1990–1993), arteriolar and venular diameters, corrected for magnification changes in case of ametropia, were measured on digitized images of one eye of 5674 participants (≥ 55 years). These participants were followed up until date of death, date of lost to follow–up, or until January 1, 2003, whichever came first. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for all–cause mortality, adjusted for age, gender, and additionally for smoking, body mass index, anti–hypertensive medication, carotid intima–media thickness, blood pressure, and total and high–density lipoprotein cholesterol. Results: After a mean follow–up of 9.9 years, 1762 participants died. Larger venular diameters were associated with an increased risk of mortality (HR per standard deviation (SD) increase: 1.07; 95% CI: 1.02–1.12), whereas arteriolar diameters were not (HR per SD decrease: 1.00; 95% CI: 0.95–1.05). The resulting arteriolar–to–venular ratio was also significantly related to mortality (HR per SD decrease: 1.07; 95% CI: 1.02–1.12). Stratification on age showed that the association between venular diameters and mortality was more prominent in participants below 75 years (HR per SD increase: 1.17; 95% CI: 1.10–1.25). The corresponding HR for participants above 75 years was 0.98 (95% CI: 0.92–1.05). Additional adjustments for other risk factors did not alter these results. Conclusions: Our data show that retinal venular dilatation predicts all–cause mortality independently of other cardiovascular risk factors. This association was more pronounced in the younger age categories.
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