| Methods for evaluation of retinal microvascular abnormalities associated with hypertension/sclerosis in the Atherosclerosis Risk in Communities Study. | |
| | |
MedLine Citation:
|
PMID: 10599656 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To develop protocols to photograph and evaluate retinal vascular abnormalities in the Atherosclerosis Risk in Communities (ARIC) Study; to test reproducibility of the grading system; and to explore the relationship of these microvascular changes with blood pressure. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Among 4 examination centers, 11,114 participants (48-73 years of age) at their third triennial examination, after excluding persons with diabetes from this analysis. METHODS: One eye of each participant was photographed by technicians with nonmydriatic fundus cameras. Reading center graders evaluated focal arteriolar narrowing, arteriovenous (AV) nicking, and retinopathy by examining slides on a light box and measured diameters of all vessels in a zone surrounding the optic disc on enhanced digitized images. To gauge generalized narrowing, vessel diameters were combined into central arteriolar and venular equivalents with formulas adjusting for branching, and the ratio of equivalents (A/V ratio) was calculated. MAIN OUTCOME MEASURES: Retinal vascular abnormalities, mean arteriolar blood pressure (MABP). RESULTS: Among 11,114 participants, photographs were obtained of 99%, with quality sufficient to perform retinal evaluations in 81%. In the 9040 subjects with usable photographs, A/V ratio (lower values indicate generalized arteriolar narrowing) ranged from 0.57 to 1.22 (median = 0.84, interquartile range = 0.10), focal arteriolar narrowing was found in 7%, AV nicking in 6%, and retinopathy in 4%. Because of attrition of subjects and limitation of methods, prevalence of abnormality was likely underestimated. Controlling for gender, race, age, and smoking status, these retinal changes were associated with higher blood pressure. For every 10-mmHg increase in MABP, A/V ratio decreased by 0.02 unit (P < 0.0001), focal arteriolar narrowing had an odds ratio (OR) of 2.00 (95% confidence interval [CI] = 1.87-2.14), AV nicking had an OR of 1.25 (95% CI = 1.16-1.34), and retinopathy had an OR of 1.25 (95% CI = 1.15-1.37). For any degree of generalized narrowing, individuals with focal narrowing had MABP approximately 8 mmHg higher than those without (P < 0.0001). Masked replicate assessment of a sample found the following reproducibility: for A/V ratio, correlation coefficient = 0.79 and median absolute difference = 0.03; for focal arteriolar narrowing, kappa = 0.45; for AV nicking, kappa = 0.61; and for retinopathy, kappa = 0.89. CONCLUSION: Protocols have been developed for nonmydriatic fundus photography and for evaluation of retinal vascular abnormalities. Several microvascular changes were significantly associated with higher blood pressure; follow-up will show whether these are predictive of later cerebrovascular or cardiovascular disease independently of other known risk factors. |
| | |
Authors:
|
L D Hubbard; R J Brothers; W N King; L X Clegg; R Klein; L S Cooper; A R Sharrett; M D Davis; J Cai |
Related Documents
:
|
8350276 - Permeability of disrupted cerebral microvessels in the frog. 3752276 - Hydraulic conductivity of venous endothelium as measured with a volume clamp method. 11728256 - Ace inhibition and vascular remodeling of resistance vessels: vascular compliance and c... 19680136 - Retinal vessel diameters and risk of hypertension: the multiethnic study of atheroscler... 21096706 - An rf-powered wireless multi-channel implantable bio-sensing microsystem. 18362236 - Matrix-array 3-dimensional echocardiographic assessment of volumes, mass, and ejection ... |
Publication Detail:
|
Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: Ophthalmology Volume: 106 ISSN: 0161-6420 ISO Abbreviation: Ophthalmology Publication Date: 1999 Dec |
Date Detail:
|
Created Date: 1999-12-21 Completed Date: 1999-12-21 Revised Date: 2010-01-13 |
Medline Journal Info:
|
Nlm Unique ID: 7802443 Medline TA: Ophthalmology Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 2269-80 Citation Subset: IM |
Affiliation:
|
ARIC Retinal Reading Center, Department of Ophthalmology & Visual Sciences, University of Wisconsin-Madison, 53705-2397, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Blood Pressure Capillaries / pathology Coronary Artery Disease / complications*, epidemiology Cross-Sectional Studies Diagnostic Techniques, Ophthalmological* Female Fundus Oculi Humans Hypertension / complications* Image Processing, Computer-Assisted / methods Male Middle Aged Photography / methods Reproducibility of Results Retinal Diseases / classification, diagnosis*, etiology Retinal Vessels / pathology* Risk Factors Sclerosis / complications United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
|
N01-HC-35125/HC/NHLBI NIH HHS; N01-HC-35126/HC/NHLBI NIH HHS; N01-HC-55015/HC/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
|
Prehosp Disaster Med. 2009 Sep-Oct;24(5):395-7
[PMID:
20066640
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Fundus photographic, fluorescein angiographic, and indocyanine green angiographic signs in successfu...
Next Document: Retinal detachment after clear lens extraction for high myopia: seven-year follow-up.