Identification of risk factors for retinal vascular events in a population-based cross-sectional study in Rumoi, Japan

Abstract

We conducted a population-based, cross-sectional study in Japan to identify risk factors for retinal vascular events separately by gender. Forty years or older participants were recruited. Fundus photographs were taken, and lifestyle and health characteristics were determined through a questionnaire and physical examinations. We compared the group of those who had retinal vascular events and those who did not. A total of 1689 participants (964 men) were deemed eligible for the study and retinal vascular events were seen in 59 subjects (3.7% of the men, 3.2% of the women). Self-reported diabetes mellitus was significantly associated with the vascular events in each gender [odds ratio (OR) = 6.97, 6.19 (men, women); 95% confidence interval (CI) 3.02-15.9, 2.25-17.0; p < 0.001]. Higher systolic blood pressure (OR = 1.03; 95% CI 1.01-1.04; p = 0.006) and lower frequency of meat consumption (OR = 0.73; 95% CI 0.54-0.99; p = 0.04) were independently associated with the vascular events in men. In women, while vascular events were associated with self-reported hypertension (OR = 2.64; 95% CI 1.03-6.74; p = 0.04), no association was seen with systolic blood pressure. Women with hypertension may need extra care, not only for blood pressure.

Figure 1

Summary of the participant groups included in the study. Among the 1731 participants, 37 were excluded because of unclear photographs that could not be used to diagnose pathological findings requiring further investigation. Suspected findings of retinal vascular events were identified in fundus photographs of 64 participants by the initial screening. Further reviews of the participants’ photographs led to the exclusion of five participants because their findings were indistinguishable from changes other than vascular events such as pigmentations. Finally, we included 1630 in the no-retinal vascular event group and 59 in the retinal vascular event group. We excluded 42 participants who either had unclear fundus photographs or who could not be definitively diagnosed as having a retinal vascular event.