Wong Tien Yin, Klein Ronald, Sharrett A Richey, Manolio Teri A, Hubbard Larry D, Marino Emily K, Kuller Lewis, Burke Gregory, Tracy Russell P, Polak Joseph F, Gottdiener John S, Siscovick David S
Singapore Eye Research Institute, Singapore, Republic of Singapore.
Ophthalmology. 2003 Apr;110(4):658-66. doi: 10.1016/S0161-6420(02)01931-0.
To describe the prevalence of retinal microvascular characteristics and their associations with atherosclerosis in elderly, nondiabetic persons.
Population-based, cross-sectional study comprising 2050 men and women aged 69 to 97 years without diabetes, living in four communities.
Participants underwent retinal photography and standardized grading of retinal microvascular characteristics, including retinopathy (e.g., microaneurysms, retinal hemorrhages), focal arteriolar narrowing, and arteriovenous nicking. In addition, calibers of retinal arterioles and venules were measured on digitized photographs to obtain an estimate of generalized arteriolar narrowing. Atherosclerosis and its risk factors were obtained from clinical examination and laboratory investigations.
Prevalence of retinal microvascular abnormalities and their associations with measures of atherosclerosis.
The prevalence of retinal microvascular abnormalities was 8.3% for retinopathy, 9.6% for focal arteriolar narrowing, and 7.7% for arteriovenous nicking. All retinal lesions were associated with hypertension (odds ratios [OR] were 1.8 for retinopathy, 2.1 for focal arteriolar narrowing, 1.5 for arteriovenous nicking, and 1.7 for generalized arteriolar narrowing). After controlling for age, gender, race, mean arterial blood pressure, and antihypertensive medication use, retinopathy was associated with prevalent coronary heart disease (OR, 1.7), prevalent myocardial infarction (OR, 1.7), prevalent stroke (OR, 2.0), presence of carotid artery plaque (OR, 1.9), and increased intima-media thickness of the common carotid (OR, 2.3; fourth vs. first quartile) and internal carotid (OR, 1.8; fourth vs. first quartile) arteries. In contrast, focal arteriolar narrowing, arteriovenous nicking, and generalized arteriolar narrowing were not associated with any measures of atherosclerosis.
Retinal microvascular abnormalities are common in older persons without diabetes and are related to hypertension. Retinopathy is associated with prevalent coronary heart disease, stroke, and carotid artery thickening, but focal and generalized arteriolar narrowing and arteriovenous nicking are not related to most measures of atherosclerosis. These data suggest that retinal microvascular abnormalities reflect processes associated with hypertension but distinct from atherosclerosis.
描述老年非糖尿病患者视网膜微血管特征的患病率及其与动脉粥样硬化的关联。
基于人群的横断面研究，纳入了居住在四个社区的2050名年龄在69至97岁之间且无糖尿病的男性和女性。
参与者接受视网膜摄影，并对视网膜微血管特征进行标准化分级，包括视网膜病变（如微动脉瘤、视网膜出血）、局灶性小动脉狭窄和动静脉交叉压迹。此外，在数字化照片上测量视网膜小动脉和小静脉的管径，以评估全身性小动脉狭窄情况。动脉粥样硬化及其危险因素通过临床检查和实验室检查获得。
视网膜微血管异常的患病率及其与动脉粥样硬化指标的关联。
视网膜病变的患病率为8.3%，局灶性小动脉狭窄为9.6%，动静脉交叉压迹为7.7%。所有视网膜病变均与高血压相关（视网膜病变的比值比[OR]为1.8，局灶性小动脉狭窄为2.1，动静脉交叉压迹为1.5，全身性小动脉狭窄为1.7）。在控制年龄、性别、种族、平均动脉血压和抗高血压药物使用后，视网膜病变与冠心病患病率（OR，1.7）、心肌梗死患病率（OR，1.7）、中风患病率（OR，2.0）、颈动脉斑块的存在（OR，1.9）以及颈总动脉（OR，2.3；第四四分位数与第一四分位数相比）和颈内动脉（OR，1.8；第四四分位数与第一四分位数相比）内膜中层厚度增加相关。相比之下，局灶性小动脉狭窄、动静脉交叉压迹和全身性小动脉狭窄与任何动脉粥样硬化指标均无关联。
视网膜微血管异常在老年非糖尿病患者中很常见，且与高血压有关。视网膜病变与冠心病、中风和颈动脉增厚的患病率相关，但局灶性和全身性小动脉狭窄以及动静脉交叉压迹与大多数动脉粥样硬化指标无关。这些数据表明，视网膜微血管异常反映了与高血压相关但与动脉粥样硬化不同的过程。
