The relation of retinal microvascular characteristics to age-related eye disease: the Beaver Dam eye study.
PURPOSE: To examine the relationship between microvascular characteristics (central retinal artery equivalent [CRAE], central retinal vein equivalent [CRVE], arteriole-to-venule ratio [AVR], focal retinal arteriolar narrowing, arteriovenous [A/V] nicking, and retinopathy) associated with systemic hypertension and ocular disease (age-related maculopathy [ARM], three types of cataract, and open-angle glaucoma). DESIGN: Population-based cohort study. METHODS: Standardized grading of microvascular characteristics was performed at baseline on fundus photographs taken on 4,926 persons aged 43 to 86 years who participated in the Beaver Dam Eye study at the baseline examination. Age-related maculopathy, cataract, and glaucoma status were determined at baseline; ARM and cataract were again determined at 5-year and 10-year follow-up examinations using standard protocols. RESULTS: While controlling for age and sex, generalized retinal arteriolar narrowing (lowest quintile of CRAE) was associated with the 10-year cumulative incidence of retinal pigment epithelial (RPE) depigmentation (risk ratio [RR] 1st vs 5th quintile, 1.93; 95% confidence interval [CI], 1.11, 3.34) and, inversely, with incident nuclear cataract (RR, 0.71; 95% CI, 0.50, 0.99). Arteriovenous nicking was associated with the incidence of early ARM (RR, 2.39; 95% CI, 1.02, 5.57). Otherwise, there were no statistically significant associations of focal arteriolar narrowing or retinopathy with incident ARM or any type of age-related cataract and no relation of CRAE, focal arteriolar narrowing, A/V nicking, or retinopathy with the prevalence of glaucoma. CONCLUSION: These data show that retinal vascular characteristics associated with hypertension are related to the incidence of ARM and nuclear cataract but not to prevalent glaucoma. Relationships, however, were weak and inconsistent.
Klein, R; Klein, BEK; Tomany, SC; Wong, TY
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