Carotid stiffness is associated with retinal microvascular dysfunction– The Maastricht Study

Abstract

Purpose : Diabetic retinopathy is one of the leading causes of blindness and is preceded by impaired microvascular autoregulation. However, potential treatment targets for these early changes are still unknown. We hypothesized that arterial stiffness, measured by aortic and carotid stiffness, may be such a target and therefore investigated the association between arterial stiffness and retinal microvascular function.

Methods : We used cross-sectional data from the Maastricht Study, a type 2 diabetes-enriched population-based cohort study (n=1,838 [51% men, mean age 59.9±8.2 years, 14.9% prediabetes, 28.4%T2D]). We standardized carotid and aortic stiffness (i.e. carotid distensibility coefficient [DC] and carotid-femoral pulse wave velocity [cfPWV]), retinal vascular dilatation response and caliber measures. We investigated associations with linear regression and adjusted for age, sex, glucose metabolism status, mean arterial pressure, heart rate, waist circumference, lipid profile, the use of lipid-modifying and blood pressure-lowering medication, smoking and alcohol consumption. In addition, we tested whether these associations were modified by sex or type 2 diabetes.

Results : After adjustment, lower carotid DC (per SD) was significantly associated with lower retinal arteriolar microvascular dilatation (SD) (-0.06 [95%CI -0.12; 0.00]), but not significantly with venular microvascular dilatation (-0.04 [-0.10; 0.02]). In addition, these associations were stronger in men and in T2D. In contrast, cfPWV was not associated with microvascular dilatation and neither carotid DC nor cfPWV were associated with CRAE or CRVE.

Conclusions : Greater carotid stiffness is associated with retinal microvascular dysfunction. Hence, carotid stiffness may be a determinant of retinal microvascular dysfunction and early diabetic retinopathy.

This is a 2020 ARVO Annual Meeting abstract.