Ophthalmology (Eye & Ear Hospital) - Research Publications

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    Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli: the atherosclerosis risk in communities & cardiovascular health studies
    Wong, Tien Yin ; Larsen, Emily K. Marino ; Klein, Ronald ; MITCHELL, PAUL ; Couper, David J. ; Klein, Barbara E. K. ; Hubbard, Larry D. ; Siscovick, David S. ; Sharrett, A. Richey (Elsevier, 2005)
    Objective: To examine the associations of retinal vein occlusion and arteriolar emboli with cardiovascular disease. Design: Population-based cross-sectional study. Participants: Pooled from the Atherosclerosis Risk in Communities Study (n = 12 642; mean age, 60 years) and the Cardiovascular Health Study (n = 2824; mean age, 79 years). Methods: Retinal vein occlusion and arteriolar emboli were identified from a single nonmydriatic retinal photograph using a standardized protocol. Photographs were also graded for arteriovenous nicking and focal arteriolar narrowing. All participants had a comprehensive systemic evaluation, including standardized carotid ultrasonography. Main Outcome Measures: Retinal vein occlusion and arteriolar emboli. Results: Prevalences of retinal vein occlusion and arteriolar emboli were 0.3% (n = 39 cases) and 0.2% (n = 34 cases), respectively. After adjusting for age, retinal vein occlusion was associated with hypertension (odds ratio OR, 2.96; 95% confidence interval CI, 1.43­6.14), systolic blood pressure (BP) (OR, 4.12; 95% CI, 1.40­12.16; highest quartile vs. lowest), diastolic BP (OR, 2.64; 95% CI, 1.07­6.46; highest quartile vs. lowest), carotid artery plaque (OR, 5.62; 95% CI, 2.60­12.16), body mass index (OR, 3.88; 95% CI, 1.23­12.18; highest quartile vs. lowest), plasma fibrinogen (OR, 3.29; 95% CI, 1.08­10.02; highest quartile vs. lowest), arteriovenous nicking (OR, 4.09; 95% CI, 2.00­8.36), and focal arteriolar narrowing (OR, 5.17; 95% CI, 2.59­10.29). After adjusting for age, retinal arteriolar emboli were associated with hypertension (OR, 3.14; 95% CI, 1.44­6.84), systolic BP (OR, 3.46; 95% CI, 1.13­10.65; highest quartile vs. lowest), prevalent coronary heart disease (OR, 2.33! ; 95% CI, 1.01­5.42), carotid artery plaque (OR, 4.62; 95% CI, 1.85­11.57), plasma lipoprotein (a) (OR, 3.6 []
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    Estrogen replacement therapy and retinal vascular caliber
    Wong, Tien Yin ; Knudtson, Michael D. ; Klein, Barbara E. K. ; Klein, Ronald ; Hubbard, Larry D. (Elsevier, 2005)
    Objective: It is unclear if estrogen replacement therapy (ERT) has an effect on the retinal circulation. In the current study, we examine the association of ERT, female reproductive factors, and retinal vascular caliber. Design: Population-based cross-sectional study. Participants: Women participants aged 43 to 84 years living in Beaver Dam, Wisconsin. Methods: Retinal photographs of participants taken at the baseline examination were digitized, and the diameters of arterioles and venules were measured using a well-established technique. Estrogen replacement therapy and female reproductive factors were ascertained by interview. Main Outcome Measures: Retinal arteriolar and venular diameters. Results: Of the 2469 women participants with data for analysis, 10.5% were current users of ERT and 7.4% were past users. After adjusting for age, blood pressure (BP), body mass index, smoking, and other factors, women who were current users of ERT had narrower retinal arteriolar and venular diameters than those who were past users or never used, with mean arteriolar diameters of 167.6 µm for current users, 170.8 µm for past users, and 170.9 µm for those who never used (P = 0.009) and mean venular diameters of 239.9 µm for current users, 244.0 µm for past users, and 243.9 µm for those who never used (P = 0.02). There was a significant trend of increasing narrowing for both arterioles (P trend, 0.01) and venules (P trend, 0.007) with increasing duration of ERT. Associations were somewhat stronger in younger women and women without a history of hypertension and cigarette smoking. Female reproductive factors (e.g., age of menarche and pregnancy) were not associated with retinal vessel diameters. Conclusions: Estrogen replacement therapy is associated with narrower retinal vessel diameters, independent of BP and other vascular factors.
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    Retinopathy in persons with impaired glucose metabolism : The Australian Diabetes Obesity and Lifestyle (AusDiab) Study
    Wong, T. ; Barr, E. ; Tapp, R. ; Harper, C. A. ; Taylor, H. R. ; Zimmet, P. ; Shaw, J. (Elsevier, 2005)
    PURPOSE: To describe risk factors and vascular disease associations of retinopathy in people with impaired glucose metabolism. DESIGN: Population-based cross-sectional study. METHODS: Retinal photographs taken of participants with impaired glucose tolerance and impaired fasting glucose were graded for retinopathy. Risk factors and cardiovascular outcomes were ascertained. RESULTS: Retinopathy was present in 69 (6.7%) of 1027 participants with impaired glucose tolerance or impaired fasting glucose. After multivariate adjustment, retinopathy was associated with prevalent stroke (odds ratio 4.2, 95% confidence interval, 1.8 to 9.7). CONCLUSIONS: Retinopathy is common in persons with impaired glucose metabolism and may be associated with prevalent stroke.