The relation of retinal microvascular characteristics to age-related eye disease: the Beaver Dam eye study

Klein, Ronald; Klein, Barbara E.K.; Tomany, Sandra C.; Wong, Tien Yin

doi:10.1016/j.ajo.2003.10.020

Cited by 74 publications

(58 citation statements)

References 43 publications

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“…This situation of chronic ischaemia is also present in causes of blindness as prevalent as aged-related macular degeneration, glaucoma or diabetic retinopathy [11][12][13]. This situation is extremely important, as today we know from epidemiological studies the relation between vascular retinal lesions and the incidence of lesions in non-ocular tissues that appear to be linked to common factors having microvascular effects.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical studies have suggested that hyperlipidaemia alone can prompt structural changes in the choroidal vascular and retinal system which over time could provoke retinal dysfunction [10]. Chronic ischaemia is also present in causes of blindness as prevalent as aged-related macular degeneration, glaucoma or diabetic retinopathy [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Choroidal Vessel Wall: Hypercholesterolaemia-Induced Dysfunction and Potential Role of Statins

Sebastián¹,

Corral²,

Montañana³

et al. 2012

Current Basic and Pathological Approaches to the Function of Muscle Cells and Tissues - From Molecules to Humans

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Choroidal Vessel Wall: Hypercholesterolaemia-Induced Dysfunction and Potential Role of Statins

Sebastián¹,

Corral²,

Montañana³

et al. 2012

Current Basic and Pathological Approaches to the Function of Muscle Cells and Tissues - From Molecules to Humans

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“…Thus far, several studies have also examined the association between retinal vascular caliber and age-related macular degeneration (AMD) [114,115,116]. The results from these studies have been inconsistent.…”

Section: Retinal Vascular Caliber and Ocular Diseasesmentioning

confidence: 93%

“…The Handan Eye Study showed that wider retinal arteriolar caliber was related to early AMD and venular caliber was not related to AMD [115]. In contrast to both these studies, cross-sectional data from the Beaver Dam Eye Study showed no association between retinal vascular calibers and AMD [116]. Furthermore, prospective data from the Beaver Dam Eye Study and the Rotterdam Study could not confirm an association between retinal vascular calibers and incident AMD [116,117].…”

Section: Retinal Vascular Caliber and Ocular Diseasesmentioning

confidence: 96%

Retinal Vascular Caliber Measurements: Clinical Significance, Current Knowledge and Future Perspectives

Ikram¹,

Ong

Cheung³

et al. 2012

Ophthalmologica

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181

187

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The retinal vasculature provides a unique window to assess vascular health noninvasively and directly in vivo. Advances in fundus photography and retinal image analysis techniques have enabled the objective and accurate assessment of quantitative retinal vascular caliber measurement. Over the last decade, large population-based studies have shown that retinal vascular calibers are associated with a wide range of subclinical (e.g. atherosclerosis, inflammation and endothelial dysfunction) and clinical cardiovascular diseases (hypertension, diabetes mellitus, stroke, kidney and heart diseases). However, while retinal image analysis provided exciting possibilities to study the pathogenesis of these diseases, its direct applicability in a clinical setting as a ‘test' to predict cardiovascular diseases is yet to be established, particularly within the context of being used as a population screening tool. Nevertheless, with continual development of retinal imaging techniques and newer understanding of the clinical significance of these retinal changes, there remains scope for the development of retinal vascular caliber measurements as a biomarker for vascular disease risk assessment in targeted areas and patient subgroups (e.g. patients with diabetes, suspected hypertension and stroke).

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“…In addition, previous studies reveal that diabetes is related to cerebral amyloid angiopathy, especially among carriers of apolipoprotein E ε4 allele (13,36), and CMBs are associated with the ε4 allele (20), suggesting that common genetic susceptibility may play a role in the association between diabetes and CMBs. Furthermore, histopathological studies show evidence of amyloid ␤ deposition in the degenerative retina associated with age-related macular degeneration (37), which has been linked to retinal microvascular signs (38). The temporality of these associations needs to be investigated in longitudinal studies, as does the long-term physical and cognitive functional implication of combined cerebral and retinal microvascular lesions (39,40).…”

Section: Discussionmentioning

confidence: 99%

Retinal and Cerebral Microvascular Signs and Diabetes

et al. 2008

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OBJECTIVE-Diabetes increases the risk for microvascular disease. The retina and the brain both have intricate microvascular systems that are developmentally similar. We sought to examine whether microvascular lesions in the retina and in the brain are associated and whether this association differs among people with and without diabetes. RESEARCH DESIGN AND METHODS-The analysis included 4,218 participants of the Icelandic population-based Age, Gene/Environment Susceptibility-Reykjavik Study who were born in 1907-1935 and who were previously followed as a part of the Reykjavik Study. Retinal focal arteriolar narrowing, arteriovenous (AV) nicking, and microaneurysms/hemorrhages were evaluated on digital retinal images of both eyes. Cerebral microbleeds (CMBs) were evaluated from magnetic resonance images. Data were analyzed with logistic and multinomial logistic regression models controlling for demographics, major cardiovascular risk factors, cerebral infarcts, and white matter lesions. D evelopmentally, the retina is an outgrowth of the brain and shares with the brain similar microvascular properties in anatomy, physiology, and metabolic activities (1,2). Microvascular systems in both the retina and the brain may be affected by atherosclerotic, hemodynamic, or other metabolic factors that affect large, small, and microblood vessels (3,4). Population-based epidemiological studies have shown that retinal microvascular abnormalities, such as arteriovenous (AV) nicking, microaneurysms, and hemorrhages, are associated with an increased risk of clinical stroke and cerebral white matter lesions (WMLs) (5-8), a marker for small-vessel disease. To date, no population-based studies have examined the relation of retinal microvascular signs to cerebral microbleeds (CMBs), which indicate the presence of hemorrhagic microvascular lesions or microangiopathy in the brain (9). CMBs are histopathologically confirmed signals on magnetic resonance image (MRI) that signify hemosiderin deposits due to frank minor hemorrhages or blood leakage through small blood vessels (10). Clinical studies suggest that CMBs are associated with an increased risk for intracerebral hemorrhages and serve as the basis for a clinical diagnosis of cerebral amyloid angiopathy (9,11,12). RESULTS-EvidenceIndividuals with diabetes are known to be at an increased risk for microvascular lesions of both the retina and the brain. Diabetes also is associated with cognitive disorders (13-15) and with brain structural changes in large and small vessels (16,17). Therefore, it is biologically plausible to hypothesize that the strength of association between retinal and cerebral microvascular lesions may be greater in people with diabetes compared with those without the disease.In this population-based study of older adults, we sought to investigate whether retinal microvascular signs are associated with microbleeds in the brain and whether the association between retinal microvascular lesions and brain microbleeds varies by diabetes status. RESEARCH DESIGN AND METHODS...

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The relation of retinal microvascular characteristics to age-related eye disease: the Beaver Dam eye study

Cited by 74 publications

References 43 publications

Choroidal Vessel Wall: Hypercholesterolaemia-Induced Dysfunction and Potential Role of Statins

Choroidal Vessel Wall: Hypercholesterolaemia-Induced Dysfunction and Potential Role of Statins

Retinal Vascular Caliber Measurements: Clinical Significance, Current Knowledge and Future Perspectives

Retinal and Cerebral Microvascular Signs and Diabetes

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