Changes in Retinal Vessel Diameter and Incidence and Progression of Diabetic Retinopathy

作者：Ronald Klein, Chelsea E. Myers, Kristine E. Lee, Ronald E. Gangnon, Barbara E.K. Klein · 发表于：Archives of Ophthalmology · 年份：2012 · DOI：10.1001/archophthalmol.2011.2560 · 被引用次数：123 · 研究领域：Retinal Diseases and Treatments、Retinal Imaging and Analysis、Retinal and Optic Conditions

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 ven...