Ethnic differences in retinal microvascular structure

Tillin, Therese; Evans, Richard; Witt, Nicholas; Sharp, Patrick; Chaturvedi, Nish; Hughes, Alun D.

doi:10.1007/s00125-008-1096-7

Cited by 17 publications

(13 citation statements)

References 10 publications

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“…This could imply that other mechanisms contribute, but it should be noted that our estimate of duration of diabetes is an imprecise measure and is likely to underestimate the true duration of exposure to impaired glucose tolerance leaving the question unresolved. Our findings in diabetic people contrast with previous reports of increased retinal arteriolar narrowing independent of blood pressure in African Americans compared with White Americans in a population study excluding diabetic individuals [47] and narrower retinal arterioles in African Caribbean people in the UK, although in that instance the greater narrowing may have been attributable to higher blood pressures [48]. In the latter study it was also noted that diabetes modified the relationship between arteriolar narrowing and elevated blood pressure.…”

Section: Discussioncontrasting

confidence: 99%

Comparison of the retinal microvasculature in European and African-Caribbean people with diabetes

et al. 2009

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Diabetes aggravates the impact of elevated BP (blood pressure) on the microcirculation, and people of African ancestry with diabetes are more susceptible to microvascular damage than Europeans. In the present study, we investigated possible differences in the retinal microcirculation in people of European and African-Caribbean ethnicity with diabetes that might account for this. A total of 51 subjects with Type 2 diabetes (age 40–65 years; 25 male; 29 African-Caribbean) were studied. Clinic and 24 h ambulatory BP, and fasting glucose, insulin and lipids were measured. Digital retinal images were analysed using custom-written semi-automatic software to determine: LDR (length/diameter ratio) and AVR (arteriolar/venular diameter ratio), branching angles, vessel tortuosity and NT (number of terminal vessel branches). Arterioles were narrower in European people with diabetes than in African-Caribbean people with diabetes [mean (S.D.) arteriolar diameter, 76 (7) compared with 82 (11) μm respectively (P=0.03); arteriolar LDR, 28.1 (8.5) compared with 23.7 (7.0) respectively (P=0.046); and AVR, 0.66 (0.21) compared with 0.90 (0.36) respectively (P=0.028)]. Ethnic differences in arteriolar LDR, arteriolar diameter and AVR were not explained by differences in BP, but were attenuated by adjustment for the duration of diabetes. There was no significant relationship between BP and arteriolar narrowing in the group as a whole, although the relationship between arteriolar LDR and systolic BP was stronger in Europeans than African-Caribbeans [β=0.08 (0.07) compared with β=0.03 (0.06); P=0.03]. In conclusion, in the presence of diabetes, a relationship between BP and retinal arteriolar diameter was not evident and implies impaired small artery remodelling in the presence of diabetes. African-Caribbean people with diabetes have wider retinal arterioles and this could contribute to enhanced microvascular damage in this ethnic group.

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Section: Discussioncontrasting

confidence: 99%

Comparison of the retinal microvasculature in European and African-Caribbean people with diabetes

et al. 2009

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“…In addition, the arteriolar optimality deviation, an indicator of endothelial dysfunction, was recently shown to be greater in African-Caribbeans than whites, independent of conventional risk factors [54].…”

Section: Retinal Architectural Changesmentioning

confidence: 99%

Retinal vascular changes and diabetic retinopathy

Nguyên¹,

Wong

2009

Curr Diab Rep

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Recent studies support the concept that the retinal vasculature may provide a summary measure of lifetime exposure to the effects of hyperglycemia. Advances in retinal photographic techniques and in image analysis have allowed objective and precise in vivo measurement of retinal vascular changes. In particular, quantitative assessment of retinopathy signs and measurement of retinal vascular caliber have greatly increased our knowledge of early microcirculatory alterations in prediabetes, diabetes, and diabetic micro- and macrovascular complications. Data from recent population-based studies suggest that retinal arteriolar and venular caliber changes reflect different pathophysiologic processes. Retinal arteriolar narrowing, for example, is associated with risk of diabetes and coronary artery disease, whereas retinal venular widening is associated with development and progression of diabetic retinopathy and risk of stroke. Studying these changes offers the potential to improve our understanding of the early pathophysiologic pathways of diabetes development and its complications. Future research will assess the ability of retinal vascular imaging to provide clinically useful prognostic information for patients with diabetes.

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“…1c) is defined as the extent to which the relationship between the parent and daughter arteriolar diameters deviates from theoretically defined optimum [24,25,26]. Griffith et al [27] showed that optimal deviation allows for the uniform distribution of sheer stress on the vessels involved.…”

Section: Methodsmentioning

confidence: 99%

Retinal Vascular Calibre, Geometry and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus

2012

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Purpose: To determine whether changes in retinal vascular calibre and geometry are associated with progression of diabetic retinopathy in type 2 diabetes (T2D). Procedures: The retinal vascular calibre and geometry of 30 subjects with more than 20 years of diagnosed T2D with no retinopathy (NR) were compared to 30 subjects that progressed to proliferative diabetic retinopathy (PDR). The images of PDR subjects included in this study were those obtained before the onset of retinopathy. The diameter of retinal arterioles (CRAE), retinal venules (CRVE), tortuosity of retinal vessels, junctional exponent deviation (JE_a) and fractal dimension (D_f) were measured using Singapore I Vessel Assessment (SIVA 3.0) software and compared using Mann-Whitney U test. Results: The median CRAE and the median CRVE were significantly wider in PDR subjects compared to NR subjects (p = 0.014 and 0.016), respectively. Curvature tortuosity of the retinal arteries and veins and D_f were significantly decreased in the PDR subjects compared to NR subjects (p = 0.015, 0.016 and 0.03, respectively). The JE_a was significantly increased in PDR subjects (p = 0.01). Conclusions: Retinal vessel calibre and geometry of the retinal vasculature may be important risk factors for the progression to PDR. More longitudinal prospective studies will be needed to further explore the findings of this study.

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Ethnic differences in retinal microvascular structure

Cited by 17 publications

References 10 publications

Comparison of the retinal microvasculature in European and African-Caribbean people with diabetes

Comparison of the retinal microvasculature in European and African-Caribbean people with diabetes

Retinal vascular changes and diabetic retinopathy

Retinal Vascular Calibre, Geometry and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus

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