Abstract
Purpose :
A hemodynamic role in the pathogenesis of age-related macular degeneration (AMD) has been proposed, but the relationship of retinal vascular parameters and AMD severity has not been evaluated. Here, we explored if retinal arterial or venous diameters, or arteriole-to-venule ratio (AVR) may be associated with AMD severity by analyzing fundus photographs from the Age-Related Eye Disease Study (AREDS).
Methods :
We evaluated field 1 color fundus photographs from 1172 eyes to measure retinal vascular parameters including central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and AVR. Images were graded by two masked graders using a semi-automated software to determine the diameters of the 6 largest venules and arterioles surrounding the optic disc and using the Parr-Hubbard formula to standardize vessel calibers. Univariate and multivariate regressions were used to determine the association of CRAE, CRVE, and AVR with age, sex, smoking status, and AMD severity based on the 9-step AMD severity score.
Results :
Both CRAE and CRVE were higher in men than women (P=0.001), and in current smokers vs. former or never-smokers (P<0.001), consistent with prior studies. In eyes without late AMD, the AMD severity score was associated with older age (P = 0.001), current smokers (P = 0.011), and higher AVR (P = 0.001), but not with CRAE or CRVE. The prevalence of choroidal neovascularization (CNV) was associated with older age (P = 0.003), but not with retinal vascular parameters (P=0.258-0.681). The prevalence of central geographic atrophy (CGA) showed a significant association with lower CRAE (P = 0.002) and possible association with lower CRVE (P = 0.045) or AVR (P = 0.080). None of these retinal vascular measurements were predictive of change in AMD severity score, CNV, or CGA at 5 years.
Conclusions :
Retinal vascular caliber parameters such as AVR may be associated with AMD severity, supporting a retinal hemodynamic contribution to the pathogenesis of this condition.
This is a 2021 ARVO Annual Meeting abstract.