Retinal venular diameter as an early indicator of progression to proliferative diabetic retinopathy with and without high-risk characteristics in African Americans with type 1 diabetes mellitus

Arch Ophthalmol. 2011 Jan;129(1):8-15. doi: 10.1001/archophthalmol.2010.340.

Abstract

Objective: To examine the relationship between retinal arteriolar and venular diameter and the 6-year progression of diabetic retinopathy (DR) in African Americans with type 1 insulin-dependent diabetes mellitus.

Methods: Included were 468 African Americans with type 1 diabetes mellitus who participated in the New Jersey 725 and who had undergone a 6-year follow-up examination. Seven standard field retinal photographs were obtained at both examinations. Computer-assisted grading, from digitized images of field 1 of baseline retinal photographs, was accomplished to determine the average diameter of retinal arterioles (central retinal arteriolar equivalent [CRAE]) and venules (central retinal venular equivalent [CRVE]). Retinal vessel diameter was examined in relation to the 6-year incidence and/or progression of DR.

Results: For right and left eyes, mean (SD) CRAE was 168.8 (16.0) μm and mean CRVE was 254.2 (25.2) μm. Both CRAE and CRVE were correlated between eyes (P < .001). Multivariate analysis with generalized estimating equations showed that larger CRVE in either the right or left eye was significantly associated with 6-year progression to either proliferative DR (PDR) or PDR with high-risk characteristics after adjusting for baseline clinical risk factors. Notably, a significant association between baseline CRVE and progression to PDR was present for eyes with no to moderate nonproliferative DR and also between baseline CRVE and progression to PDR with high-risk characteristics for eyes with no or nonproliferative DR.

Conclusion: Larger retinal venular diameter is an independent and early indicator of progression to either PDR or PDR with high-risk characteristics in African Americans with type 1 diabetes mellitus.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • African Americans / ethnology*
  • Arterioles / pathology
  • Child
  • Chromatography, High Pressure Liquid
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 1 / ethnology*
  • Diabetic Retinopathy / diagnosis*
  • Diabetic Retinopathy / ethnology*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Incidence
  • Male
  • New Jersey / epidemiology
  • Retinal Vessels / pathology*
  • Risk Factors
  • Venules / pathology
  • Young Adult

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human