Relationship of Retinal Vessel Caliber with Age-Related Macular Degeneration

Abstract

Purpose. Evaluate the relationship between retinal vascular caliber and age-related macular degeneration (AMD) severity or progression. Methods. A retrospective secondary analysis of 1172 fundus photographs and clinical data from the prospective Age-Related Eye Disease Study (AREDS). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) were measured using the Parr–Hubbard–Knudtson formula. Univariate and multivariate regressions were used to determine the association of CRAE, CRVE, and AVR with age, sex, smoking status, presence of cilioretinal artery, and AMD severity at baseline and 5 years using the 9-step AMD severity score. Results. Only CRAE and CRVE were higher in men ( P < 0.001 ), current smokers ( P < 0.001 ), and the eyes with a cilioretinal artery ( P = 0.009 − 0.043 ). AMD severity was greater in older patients ( P = 0.001 ), current smokers ( P = 0.012 ), the eyes without a cilioretinal artery ( P = 0.001 ), and lower AVR ( P = 0.034 ) on multivariate regression but was not influenced by CRAE or CRVE ( P = 0.240 − 0.500 ). Choroidal neovascularization (CNV) presence was associated with older age ( P = 0.003 ) and absence of a cilioretinal artery ( P = 0.009 ), while central geographic atrophy (CGA) was associated with narrower CRAE ( P = 0.002 ) and possibly AVR ( P = 0.046 ). None of the retinal vessel parameters were predictive of AMD severity score or new onset of CNV or CGA at 5 years. Conclusion. A lower arteriole-to-venule ratio may be associated with AMD severity, with narrower arterioles seen in the eyes with geographic atrophy, suggesting a role of the retinal vasculature in AMD pathophysiology. This trial is registered with ClinicalTrials.gov Identifier: NCT00000145.

The Relationship between Dietary Calcium and Age-Related Macular Degeneration

“…In a previous study, low serum PTH levels were suggested to be associated with retinal vascular diameters and a decreased risk of retinal microvascular impairment [ 70 ]. Pathogenesis of ARMD has proposed that retinal vascular diameters was associated with the severity of ARMD [ 71 ]. Trinh et al demonstrated that retinal vascular length and vascular diameter were all significantly decreased and narrowed in patients with ARMD [ 72 ].…”

Personalizing Nutrition Strategies: Bridging Research and Public Health

“…Calcium is an essential micronutrient that participates in numerous vital physiological functions, and although most studies on the role of calcium have focused on bone health, attention has recently been paid to the effects of dietary calcium and calcium supplements on other health outcomes [ 414 ]. It has been suggested that dietary calcium is related to blood pressure by regulating intracellular calcium in vascular smooth muscle cells [ 415 ]. It is also related to retinal vascular diameter and length, which are important in patients with age-related macular degeneration, as this decreases and narrows during the course of the disease [ 416 , 417 ].…”

Identifying geographic atrophy

“…OCT angiography has been utilized to demonstrate that flow impairment of the choriocapillaris around GA lesions could predict progression of GA [40]. Retinal vessel caliber has also been associated with AMD severity; narrower arterioles have been noted eyes with geographic atrophy, but are not necessarily predictive of the development of central GA [41].…”