Abstract
Abstract: :
Purpose: To examine the relationship of retinal microangiopathic abnormalities with the amount of coronary calcium. Methods: In a prospective, cross–sectional study 88 male and 74 female subjects (30–65 years) were examined by (1) 45° retinal digital photography (KOWA Nonmydriatic fundus camera), (2) electron beam tomography or multislice spiral computed tomography of the heart and (3) Scanning Laser Doppler Flowmetry (HRF). It was evaluated the presence of generalized retinal arteriolar narrowing (arteriole–to–venule ratio = av–ratio), of retinal microangiopathic abnormalities (RMA), the amount of coronary calcium (by Agatston score) and the retinal vessel wall thickness (RVWT). The Framingham risk score was calculated. Based on the age–standardized av–ratio, the RMA and the RVWT a combined microangiopathic risk score (COMIA) with 6 levels (0 =no risk to 5=highest risk) was calculated. Statistics were performed by SPSS 10.0 (correlations and logistic regression analysis , *p<0.05, **p<0.001). Results: The av–ratio and the COMIA risk score correlated significantly with the Framingham risk score (r=–0.210*; respectively r= 0.301**) and the Agatston score (r = –0.189*; respectively r=0.186*). The COMIA risk score significantly modeled the Agatston score (p< 0.05). In male subjects the correlations between COMIA vs. Framinghman and COMIA vs. Agatston were stronger (r=0.506**, r=0.385**). In comparison to patients in COMIA risk groups 0–4 the relative risk of male subjects in the highest COMIA risk group 5 was 1.7 times higher to have coronary calcifications (RR 1.752; OR 4.307). In contrast, in female subjects we did not find any significant correlations. Conclusions: Generalized retinal arteriolar narrowing and retinal microangiopathic abnormalities were significantly associated with the amount of coronary calcification. The retinal risk score COMIA might be a new prognostic tool in prevention medicine concerning coronary heart disease events.
Keywords: retina • clinical (human) or epidemiologic studies: risk factor assessment • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled