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Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy.

Publication ,  Journal Article
Klein, R; Klein, BEK; Moss, SE; Wong, TY
Published in: Ophthalmology
October 2007

OBJECTIVE: To describe the relationship of retinal arteriolar and venular calibers to the long-term incidence of microvascular and macrovascular complications in people with type 2 diabetes. DESIGN: Population-based prospective study. PARTICIPANTS: One thousand three hundred seventy persons diagnosed to have diabetes at > or =30 years of age in south central Wisconsin participated in the baseline examination from 1980 to 1982, 987 in the 4-year follow-up, and 533 in the 10-year follow-up. METHODS: Computer-assisted grading was used to determine the average caliber of retinal arterioles (central retinal arteriolar equivalent [CRAE]) and retinal venules (central retinal venular equivalent [CRVE]) at all examinations. MAIN OUTCOME MEASURES: Incidence and progression of diabetic retinopathy; incidence of proliferative diabetic retinopathy and macular edema; incidence of nephropathy, neuropathy, and lower extremity amputation; and ischemic heart disease, stroke, and overall mortality. RESULTS: While adjusting for other factors, smaller CRAE was associated with the 14-year cumulative incidence of lower extremity amputation (odds ratio [OR], first vs. second to fourth quartiles, 2.20; 95% confidence interval [CI], 1.14-4.24; P = 0.02), 22-year all-cause mortality (hazard ratio [HR], 1.18; 95% CI, 1.02-1.38; P = 0.03), and 22-year stroke mortality (HR, 1.47; 95% CI, 1.04-2.07; P = 0.03) but not with the other end points. Larger CRVE was associated with the 14-year incidence of diabetic nephropathy (OR, fourth vs. first to third quartiles, 2.08; 95% CI, 1.47-2.94; P<0.001) and 22-year stroke mortality (HR, 1.71; 95% CI, 1.20-2.44; P = 0.003) but with none of the other end points. CONCLUSIONS: Retinal vessel caliber is independently associated with risk of incident nephropathy, lower extremity amputation, and stroke mortality in persons with type 2 diabetes. Measurement of retinal vessel caliber from photographs may provide additional information for the prediction of these events.

Duke Scholars

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

October 2007

Volume

114

Issue

10

Start / End Page

1884 / 1892

Location

United States

Related Subject Headings

  • Wisconsin
  • Venules
  • Stroke
  • Risk Factors
  • Retinal Vein
  • Retinal Artery
  • Prospective Studies
  • Ophthalmology & Optometry
  • Myocardial Ischemia
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Klein, R., Klein, B. E. K., Moss, S. E., & Wong, T. Y. (2007). Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmology, 114(10), 1884–1892. https://doi.org/10.1016/j.ophtha.2007.02.023
Klein, Ronald, Barbara E. K. Klein, Scot E. Moss, and Tien Y. Wong. “Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy.Ophthalmology 114, no. 10 (October 2007): 1884–92. https://doi.org/10.1016/j.ophtha.2007.02.023.
Klein, Ronald, et al. “Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy.Ophthalmology, vol. 114, no. 10, Oct. 2007, pp. 1884–92. Pubmed, doi:10.1016/j.ophtha.2007.02.023.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

October 2007

Volume

114

Issue

10

Start / End Page

1884 / 1892

Location

United States

Related Subject Headings

  • Wisconsin
  • Venules
  • Stroke
  • Risk Factors
  • Retinal Vein
  • Retinal Artery
  • Prospective Studies
  • Ophthalmology & Optometry
  • Myocardial Ischemia
  • Middle Aged