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The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy.
Ophthalmology. 2018 11; 125(11):1784-1792.O

Abstract

PURPOSE

To examine the relationships of retinal vessel geometric characteristics (RVGCs) to the incidence and progression of diabetic retinopathy (DR).

DESIGN

Observational, prospective cohort study.

PARTICIPANTS

Nine hundred ninety-six persons with type 1 diabetes mellitus (T1DM) and 1370 persons with type 2 diabetes mellitus (T2DM) seen at a baseline examination who were eligible for follow-up examinations at subsequent 5-year intervals. A total of 3846 person-interval data from these follow-up examinations are the basis for the analyses.

METHODS

Diabetic retinopathy and macular edema were assessed by grading of 30° stereoscopic color fundus photographs. Retinal vessel geometric characteristics were assessed using the Singapore I Vessel Assessment program from a digitized copy of 1 of the field 1 fundus photographs obtained at baseline and follow-up.

MAIN OUTCOME MEASURES

The 5-year incidence of any DR, progression of DR, and incidence of proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME) in right eyes.

RESULTS

Incident DR occurred in 45%, progression in 32%, PDR in 10%, and CSME in 5%. While adjusting for glycated hemoglobin, duration of diabetes, and other factors, retinal arteriolar simple tortuosity was associated significantly with the incidence of any DR (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.01-1.35). Retinal venular branching angle was associated significantly with progression of DR (OR, 1.18; 95% CI, 1.03-1.36), retinal venular curvature tortuosity was associated significantly with the incidence of PDR (OR, 1.15; 95% CI, 1.01-1.30), and retinal venular branching angle (OR, 1.41; 95% CI, 1.10-1.82) was associated significantly with the incidence of CSME. There were no significant associations of other RVGCs with any of the DR outcomes in the full multivariate model. Inclusion of all possible RVGCs did not improve the predictive value of the models that already included retinal vessel diameter and baseline DR severity level.

CONCLUSIONS

Retinal vessel geometric characteristics of the retinal venules were associated with progression of DR; however, most of the RVGCs measured from digitized fundus photographs added little to the assessment of risk of incidence and progression of DR when other risk factors were considered in T1DM and T2DM.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin. Electronic address: kleinr@epi.ophth.wisc.edu.Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin.Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin.Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States.Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin.Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin.Department of Ophthalmology & Visual Sciences, Duke-NUS Medical School, Singapore, Republic of Singapore.Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29779685

Citation

Klein, Ronald, et al. "The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy." Ophthalmology, vol. 125, no. 11, 2018, pp. 1784-1792.
Klein R, Lee KE, Danforth L, et al. The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy. Ophthalmology. 2018;125(11):1784-1792.
Klein, R., Lee, K. E., Danforth, L., Tsai, M. Y., Gangnon, R. E., Meuer, S. E., Wong, T. Y., Cheung, C. Y., & Klein, B. E. K. (2018). The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy. Ophthalmology, 125(11), 1784-1792. https://doi.org/10.1016/j.ophtha.2018.04.023
Klein R, et al. The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy. Ophthalmology. 2018;125(11):1784-1792. PubMed PMID: 29779685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy. AU - Klein,Ronald, AU - Lee,Kristine E, AU - Danforth,Lorraine, AU - Tsai,Michael Y, AU - Gangnon,Ronald E, AU - Meuer,Stacy E, AU - Wong,Tien Y, AU - Cheung,Carol Y, AU - Klein,Barbara E K, Y1 - 2018/05/18/ PY - 2017/02/21/received PY - 2018/04/16/revised PY - 2018/04/17/accepted PY - 2018/5/22/pubmed PY - 2019/9/14/medline PY - 2018/5/22/entrez SP - 1784 EP - 1792 JF - Ophthalmology JO - Ophthalmology VL - 125 IS - 11 N2 - PURPOSE: To examine the relationships of retinal vessel geometric characteristics (RVGCs) to the incidence and progression of diabetic retinopathy (DR). DESIGN: Observational, prospective cohort study. PARTICIPANTS: Nine hundred ninety-six persons with type 1 diabetes mellitus (T1DM) and 1370 persons with type 2 diabetes mellitus (T2DM) seen at a baseline examination who were eligible for follow-up examinations at subsequent 5-year intervals. A total of 3846 person-interval data from these follow-up examinations are the basis for the analyses. METHODS: Diabetic retinopathy and macular edema were assessed by grading of 30° stereoscopic color fundus photographs. Retinal vessel geometric characteristics were assessed using the Singapore I Vessel Assessment program from a digitized copy of 1 of the field 1 fundus photographs obtained at baseline and follow-up. MAIN OUTCOME MEASURES: The 5-year incidence of any DR, progression of DR, and incidence of proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME) in right eyes. RESULTS: Incident DR occurred in 45%, progression in 32%, PDR in 10%, and CSME in 5%. While adjusting for glycated hemoglobin, duration of diabetes, and other factors, retinal arteriolar simple tortuosity was associated significantly with the incidence of any DR (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.01-1.35). Retinal venular branching angle was associated significantly with progression of DR (OR, 1.18; 95% CI, 1.03-1.36), retinal venular curvature tortuosity was associated significantly with the incidence of PDR (OR, 1.15; 95% CI, 1.01-1.30), and retinal venular branching angle (OR, 1.41; 95% CI, 1.10-1.82) was associated significantly with the incidence of CSME. There were no significant associations of other RVGCs with any of the DR outcomes in the full multivariate model. Inclusion of all possible RVGCs did not improve the predictive value of the models that already included retinal vessel diameter and baseline DR severity level. CONCLUSIONS: Retinal vessel geometric characteristics of the retinal venules were associated with progression of DR; however, most of the RVGCs measured from digitized fundus photographs added little to the assessment of risk of incidence and progression of DR when other risk factors were considered in T1DM and T2DM. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/29779685/The_Relationship_of_Retinal_Vessel_Geometric_Characteristics_to_the_Incidence_and_Progression_of_Diabetic_Retinopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(18)30530-X DB - PRIME DP - Unbound Medicine ER -