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Retinal vessel diameter and open-angle glaucoma: the Blue Mountains Eye Study.
Ophthalmology 2005; 112(2):245-50O

Abstract

PURPOSE

To examine the relationship between open-angle glaucoma (OAG) and retinal vessel diameter among baseline participants in the Blue Mountains Eye Study.

DESIGN

Population-based cross-sectional study.

PARTICIPANTS

The study included 3654 persons older than 49 years, representing 82.4% of permanent residents living in an area west of Sydney.

METHODS

Participants had a detailed eye examination, including automated perimetry and stereo optic disc photography. A computer-assisted program measured retinal vessel diameters from digitized photographs of right eyes.

MAIN OUTCOME MEASURES

Open-angle glaucoma was diagnosed from matching visual field defects and optic disc cupping, without reference to intraocular pressure (IOP) level. Ocular hypertension was defined as IOP of >21 mmHg in either eye, without matching glaucomatous optic disc and field changes. Average retinal vessel diameters, measured from right eyes, were summarized as arteriolar and venular equivalents. The lowest quintile of the arteriolar equivalent or arteriole-to-venule ratio was used to define generalized retinal arteriolar narrowing.

RESULTS

The study included 3314 participants, after excluding those with incomplete data or nonglaucomatous optic nerve disease. Of persons included, 59 (1.8%) had evidence of glaucomatous damage affecting the right eye, 3065 (92.5%) had no damage to either eye, and 163 (4.9%) had ocular hypertension. Right eyes with glaucomatous damage had significantly narrower retinal arteriolar diameters (183+/-2.6 microm) than eyes without glaucoma (194+/-0.4 microm, P = 0.0001) or eyes with ocular hypertension (195+/-1.6 microm, P = 0.0002), after adjusting for age, mean arterial blood pressure, and other confounding variables, including refraction. Right eyes with glaucomatous damage were at least 2 times more likely to have generalized retinal arteriolar narrowing than eyes without glaucoma (odds ratio, 2.7; 95% confidence interval, 1.5-4.8).

CONCLUSIONS

These population-based data suggest that generalized retinal arteriolar narrowing, an indicator of localized vascular change, is significantly associated with optic nerve damage caused by OAG. It is not clear whether such a retinal arteriolar change reflects an ischemic process leading to optic nerve damage or results from loss of retinal neurons secondary to glaucoma.

Authors+Show Affiliations

Centre for Vision Research, Department of Ophthalmology and the Westmead Millennium Institute, University of Sydney, Westmead Hospital, Sydney, NSW, Australia. paul_mitchell@wmi.usyd.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15691558

Citation

Mitchell, Paul, et al. "Retinal Vessel Diameter and Open-angle Glaucoma: the Blue Mountains Eye Study." Ophthalmology, vol. 112, no. 2, 2005, pp. 245-50.
Mitchell P, Leung H, Wang JJ, et al. Retinal vessel diameter and open-angle glaucoma: the Blue Mountains Eye Study. Ophthalmology. 2005;112(2):245-50.
Mitchell, P., Leung, H., Wang, J. J., Rochtchina, E., Lee, A. J., Wong, T. Y., & Klein, R. (2005). Retinal vessel diameter and open-angle glaucoma: the Blue Mountains Eye Study. Ophthalmology, 112(2), pp. 245-50.
Mitchell P, et al. Retinal Vessel Diameter and Open-angle Glaucoma: the Blue Mountains Eye Study. Ophthalmology. 2005;112(2):245-50. PubMed PMID: 15691558.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retinal vessel diameter and open-angle glaucoma: the Blue Mountains Eye Study. AU - Mitchell,Paul, AU - Leung,Harry, AU - Wang,Jie Jin, AU - Rochtchina,Elena, AU - Lee,Anne J, AU - Wong,Tien Y, AU - Klein,Ronald, PY - 2004/02/06/received PY - 2004/08/09/accepted PY - 2005/2/5/pubmed PY - 2005/2/17/medline PY - 2005/2/5/entrez SP - 245 EP - 50 JF - Ophthalmology JO - Ophthalmology VL - 112 IS - 2 N2 - PURPOSE: To examine the relationship between open-angle glaucoma (OAG) and retinal vessel diameter among baseline participants in the Blue Mountains Eye Study. DESIGN: Population-based cross-sectional study. PARTICIPANTS: The study included 3654 persons older than 49 years, representing 82.4% of permanent residents living in an area west of Sydney. METHODS: Participants had a detailed eye examination, including automated perimetry and stereo optic disc photography. A computer-assisted program measured retinal vessel diameters from digitized photographs of right eyes. MAIN OUTCOME MEASURES: Open-angle glaucoma was diagnosed from matching visual field defects and optic disc cupping, without reference to intraocular pressure (IOP) level. Ocular hypertension was defined as IOP of >21 mmHg in either eye, without matching glaucomatous optic disc and field changes. Average retinal vessel diameters, measured from right eyes, were summarized as arteriolar and venular equivalents. The lowest quintile of the arteriolar equivalent or arteriole-to-venule ratio was used to define generalized retinal arteriolar narrowing. RESULTS: The study included 3314 participants, after excluding those with incomplete data or nonglaucomatous optic nerve disease. Of persons included, 59 (1.8%) had evidence of glaucomatous damage affecting the right eye, 3065 (92.5%) had no damage to either eye, and 163 (4.9%) had ocular hypertension. Right eyes with glaucomatous damage had significantly narrower retinal arteriolar diameters (183+/-2.6 microm) than eyes without glaucoma (194+/-0.4 microm, P = 0.0001) or eyes with ocular hypertension (195+/-1.6 microm, P = 0.0002), after adjusting for age, mean arterial blood pressure, and other confounding variables, including refraction. Right eyes with glaucomatous damage were at least 2 times more likely to have generalized retinal arteriolar narrowing than eyes without glaucoma (odds ratio, 2.7; 95% confidence interval, 1.5-4.8). CONCLUSIONS: These population-based data suggest that generalized retinal arteriolar narrowing, an indicator of localized vascular change, is significantly associated with optic nerve damage caused by OAG. It is not clear whether such a retinal arteriolar change reflects an ischemic process leading to optic nerve damage or results from loss of retinal neurons secondary to glaucoma. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/15691558/Retinal_vessel_diameter_and_open_angle_glaucoma:_the_Blue_Mountains_Eye_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(04)01458-7 DB - PRIME DP - Unbound Medicine ER -