Retinal Vascular Changes in Pre-Diabetes and Prehypertension

Nguyen, Thanh T.; Wang, Jie Jin; Wong, Tien Yin

doi:10.2337/dc07-0732

Cited by 224 publications

(134 citation statements)

References 113 publications

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“…[26][27][28] In contrast to the current findings, we found no association between retinal arteriolar or venular calibre and retinopathy lesions in participants without diabetes, supporting a concept that retinopathy signs in persons without diabetes may be due to mechanisms different from that for diabetic retinopathy, such as hypertension. 11,29 The strengths of this study include its large population-based sample, use of standardized methods to measure retinal vascular calibre, and grade retinopathy. There are important limitations to this study, which should be noted.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Several studies have shown that subtle variations in retinal vascular calibre are related to prediabetes, diabetes development, and diabetic retinopathy. [5][6][7][8][9][10][11] The Blue Mountain Eye Study (BMES) 10 and the Australian Diabetes, Obesity, and Lifestyle (AusDiab) 8 reported that wider retinal arterioles are associated with diabetes, whereas wider retinal venules are associated with diabetic retinopathy. However, most earlier studies examined only white populations.…”

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confidence: 99%

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Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study

Islam

Nguyen

Wang

et al. 2008

Eye

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Purpose To describe the relationship of retinal vascular calibre with diabetes and diabetic retinopathy in an Asian population. Methods A total of 3280 (78.7% response) subjects, aged 40-80 years, of Malay ethnicity residing in Singapore participated in this population-based, cross-sectional study. Retinal vascular calibre was measured and summarized using a validated computer programme from digital retinal photographs. Diabetic retinopathy signs were graded from photographs using the modified Airlie House classification. Results Of the 3004 subjects with data for this analysis, 682 (22.7%) had diabetes, of whom 194 (28.4%) had retinopathy. After multivariable adjustment, retinal arteriolar calibre was significantly wider in persons with diabetes (141 vs 139 lm, Po0.001); venular calibre was not associated with diabetes (P ¼ 0.93). Among participants with diabetes, venular calibre increased from 218.7 lm in those without retinopathy to 231.1 lm in those with moderate and 231.4 lm in those with severe retinopathy (P for trend ¼ o0.001); arteriolar calibre was not associated with diabetic retinopathy. Conclusions This study shows wider retinal arterioles in diabetes and wider venules in those with diabetic retinopathy in an Asian population. These findings confirm earlier data on white population, supporting the concept that a quantitative assessment of retinal vasculature may provide further insights into early diabetic microvascular damage.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study

Islam

Nguyen

Wang

et al. 2008

Eye

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“…Recent studies have shown that alterations in the retinal architecture, as reflected by variations in retinal vascular calibre, may be a marker of prediabetes, diabetes and its microvascular complications [1][2][3] measurements, however, offer information on a single specific variable of the retinal vascular network.…”

Section: Introductionmentioning

confidence: 99%

Retinal fractal dimension is increased in persons with diabetes but not impaired glucose metabolism: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

et al. 2010

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Aims/hypothesis The fractal dimension (D f ) of the retinal vasculature is a global measure of its branching pattern complexity. We examined the relationship of retinal D f with diabetes. Methods We conducted a cross-sectional study of 1,577 participants with diabetes and impaired glucose metabolism and normal controls from the population-based Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Retinal D f was quantified from fundus photographs using a computerbased programme and diabetes status was determined by oral glucose tolerance test based on the WHO criteria. Results After adjustment for age, sex and vascular risk factors, persons with higher retinal D f were more likely to have diabetes (OR 1.56; 95% CI 1.14-2.14, highest vs lowest fractal tertile). This relationship remained with further adjustment for retinal arteriolar calibre and presence of retinopathy (OR 1.64; 95% CI 1.19-2.27), and after excluding participants with retinopathy (OR 1.60; 95% CI 1.16-2.21). Retinal D f was not related to impaired glucose tolerance or impaired fasting glucose (OR 1.19; 95% CI 0.85-1.67). Conclusions/interpretation Individuals with diabetes, but not with impaired glucose metabolism, have greater retinal D f , reflecting greater complexity of the retinal vasculature. Our findings suggest the presence of early microvascular changes in the retinal vasculature of persons with diabetes, even in the absence of overt retinopathy.

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“…Epidemiological studies have shown that narrower retinal arterioles are associated with CVD in women and are predictive of future hypertension development [13,28]. Narrow retinal arterioles are most strongly associated with past and present blood pressure levels.…”

Section: Discussionmentioning

confidence: 99%

“…Wider venules are most strongly associated with increased risk of stroke in both men and women and may be predictive of future development of type 2 diabetes and also retinopathy in adults with existing diabetes [14,28]. Systemic determinants of wider venules appear to be obesity, blood glucose levels and smoking status.…”

Section: Discussionmentioning

confidence: 99%

Increasing fruit and vegetable intake has no effect on retinal vessel caliber in adults at high risk of developing cardiovascular disease

McEvoy

Wallace

Hamill

et al. 2016

Nutrition, Metabolism and Cardiovascular Diseases

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Retinal Vascular Changes in Pre-Diabetes and Prehypertension

Cited by 224 publications

References 113 publications

Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study

Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study

Retinal fractal dimension is increased in persons with diabetes but not impaired glucose metabolism: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

Increasing fruit and vegetable intake has no effect on retinal vessel caliber in adults at high risk of developing cardiovascular disease

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