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. 2012 Jun;130(6):749-55.
doi: 10.1001/archophthalmol.2011.2560.

Changes in retinal vessel diameter and incidence and progression of diabetic retinopathy

Ronald Klein  1 , Chelsea E Myers, Kristine E Lee, Ronald Gangnon, Barbara E K Klein
Affiliations

Changes in retinal vessel diameter and incidence and progression of diabetic retinopathy

Ronald Klein et al. Arch Ophthalmol. 2012 Jun.

Abstract

Objective: To describe the relationship of change in retinal vessel diameters to the subsequent 6-year incidence and progression of diabetic retinopathy (DR) and incidence of proliferative diabetic retinopathy (PDR) and macular edema (ME) in persons with diabetes mellitus.

Design: A total of 1098 persons with diabetes who had DR graded from fundus photographs and had computer-assisted measurements of the central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent(CRVE) participated in examinations in 1980-1982, 1984-1986, and 1990-1992.

Results: During the first 4-year period, the mean change in CRAE and CRVE was −0.37 and 2.54 μm, respectively.The 6-year incidence and progression of DR and the incidence of PDR and ME from 1984-1986 to 1990-1992 were 56%, 39%, 15%, and 11%, respectively. In multivariate analyses, while controlling for duration, diabetes type, and other factors, an increase of 10 μm in CRVE from 1980-1982 to 1984-1986 was associated with increases in the 6-year incidence of DR (odds ratio [OR],1.26; 95% CI, 1.10-1.43), progression of DR (OR, 1.21;95% CI, 1.12-1.30), incidence of PDR (OR, 1.19; 95%CI, 1.07-1.32), and incidence of ME (OR, 1.16; 95% CI,1.03-1.31). No interactions of these associations by diabetes type were found (data not shown). Change in CRAE was unrelated to the incidence or progression of DR (data not shown).

Conclusions: Independent of DR severity level, glycemic control, and other factors, widening of the retinal venular but not arteriolar diameter was associated with subsequent incidence and progression of DR. The CRVE may provide additional information regarding the risk of incidence and progression of DR beyond traditional risk factors.

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Figures

Figure 1
Figure 1
Participation and reasons for exclusion in the study. CRAE, central retinal arteriolar equivalent; CRVE, central retinal venular equivalent; PDR, proliferative diabetic retinopathy; WESDR, Wisconsin Epidemiologic Study of Diabetic Retinopathy.
Figure 2
Figure 2
Correlation of change between the right and left eyes of participants from baseline to the 4-year follow-up in the Wisconsin Epidemiologic Study of Diabetic Retinopathy in A. central retinal venular equivalent (CRVE) and B. central retinal arteriolar equivalent (CRAE).
See this image and copyright information in PMC

References

    1. Klein R, Klein BEK. Vision disorders in diabetes. In: Harris MI, Cowie CC, Stern MP, Boyko EJ, Reiber GE, Bennett PH, editors. Diabetes in America. 2nd Edition. National Diabetes Data Group, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health; Bethesda, MD: 1995. pp. 293–338. NIH Publication No. 95-1468.
    1. Klein BE, Klein R, McBride PE, et al. Cardiovascular disease, mortality, and retinal microvascular characteristics in type 1 diabetes: Wisconsin epidemiologic study of diabetic retinopathy. Arch Intern Med. 2004;164(17):1917–1924. - PubMed
    1. Klein R, Klein BE, Moss SE, et al. The relation of retinal vessel caliber to the incidence and progression of diabetic retinopathy: XIX: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch Ophthalmol. 2004;122(1):76–83. - PubMed
    1. Klein R, Klein BE, Moss SE, Wong TY. Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmology. 2007;114(10):1884–1892. - PubMed
    1. Wong TY. Retinal vessel diameter as a clinical predictor of diabetic retinopathy progression: time to take out the measuring tape. Arch Ophthalmol. 2011;129(1):95–96. - PubMed

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