Prevalence of retinal vascular anomalies in the German population: results from the Gutenberg Health Study

Abstract

Purpose : To determine the prevalence of retinal vascular anomalies in the general population in Germany and to analyse potential associations with ocular and systemic factors.

Methods : The Gutenberg Health Study is a population-based cohort study, including 15.010 participants aged 35-74 years. Fundus photographs of the macula and the optic disc were performed. Vascular anomalies of the retina were graded according to a prespecified grading scheme on these fundus images. The prevalence was computed for in at least one and for both eyes. Multivariable logistic regression analysis including generalized estimating equations was conducted to assess associated factors.

Results : 12.956 participants (mean age 55.0±11.1 years; 49,8% female; 25.609 eyes) were included with a gradable fundus photograph. Retinal arterial tortuosity was present in 5.9% in at least one eye and in 3.7% in both eyes. Systolic (OR= 1.01 per mmHg, p=0.0039) and diastolic (OR= 0.98 per mmHg, p=0.0039) arterial blood pressure, LDL levels (OR= 1.0 per mg/dl, p=0.036) and spherical equivalent (OR= 1.06 per dpt, p<0.0001) were associated. Birth weight (OR= 0.97 per 100g, p<0.0001) and age (OR= 0.85 per 10 years, p=0.0004) were inversely associated, while HDL, BMI and smoking were not associated. Retinal venous tortuosity was present in 1.6% in at least one eye and in 0.6% in both eyes. Systolic (OR= 1.03 per mmHg, p<0.0001) and diastolic (OR= 0.94 per mmHg, p<0.0001) arterial blood pressure, body-mass-index (OR= 1.07 per kg/m², p<0.0001) and smoking (OR= 1.75, p=0.0073) were associated. There was no association with birth weight, spherical equivalent, LDL or HDL.
Temporal cilioretinal arteries were prevalent in at least one eye in 40.2% and in 9.2% in both eyes. Spherical equivalent was associated with the prevalence of temporal cilioretinal arteries (OR= 1.03 per dpt, p=0.00057). Branch building cilioretinal arteries had a prevalence of 0.5% in at least one eye and were present in both eyes in one study participant.

Conclusions : This study describes retinal vascular anomalies for the first time in a German population. Temporal ciolioretinal arteries were inversely associated with myopia and thus might be protective. Retinal arterial and venous tortuosity are both associated with cardiovascular risk factors, while retinal arterial tortuosity is also associated with a lower birth weight.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.