Background: Cerebral and retinal vessels behave similarly under the influence of vascular risk factors. Several groups have shown that retinal microvascular abnormalities represent an independent risk factor with rega...Background: Cerebral and retinal vessels behave similarly under the influence of vascular risk factors. Several groups have shown that retinal microvascular abnormalities represent an independent risk factor with regard to strokes and heart attacks. Aim of the Study: The aim of this study was to perform a prospective screening examinationwith regard to retinalmicrovascular abnormalities as well as an extended vessel diagnosis in a subgroup of patients with lower arteriovenous risk values. Methods: In the course of a prospective cross-sectional study (“Talking Eyes”) between 1.9.2001 and 1.8.2002 a telemedical-supported screening of the retina (study 1) was carried out in 7,163 subjects. The patients were selected without any inclusion or exclusion criteria. The mean age was 48.2±8 years (18-83 years) with a sex distribution of 39.2%females to 60.8%males. Digital fundus photos of the right and left eyes were taken for all patients. The pictures were taken without pupil dilation using a CANON-NM camera. The pictures and case histories were stored in a central server using web-based software (MedStage, Siemens). In a central reading centre, the arteriovenous ratio of both eyes was determined telemedically using the Parr-Hubbard formula and the retinas subjected to a standardised examination by an ophthalmologist. The retinal risk factor was calculated on the basis of the arteriovenous ration, the presence of microvascular abnormalities and the case history. The reproducibility of measurement of the arteriovenous ratio (Kronbach alpha coefficient) was evaluated by double measurements on 1,332 images. In a subgroup of study 1 with arteriovenous ratio values < 0.76 (N=107), an extended vessel diagnosis with measurement of 24-h blood pressure and vessel-relevant blood values (homocysteine, cholesterol, LDL, HDL, CRP, TG, HbA1c) was carried out (study II). Results: Study 1: The Kronbach alpha coefficient as a measure of reproducibility amounted to 0.77. The mean arteriovenous ratio of the retinal vessels was 0.83±0展开更多
Obsjective: To examine the relation between diameters of the retinal arterioles and 10 year incidence of hypertension. Design: Population based prospective cohort study. Setting: Beaver Dam eye study. Participants: 24...Obsjective: To examine the relation between diameters of the retinal arterioles and 10 year incidence of hypertension. Design: Population based prospective cohort study. Setting: Beaver Dam eye study. Participants: 2451 normotensive people aged 43 to 84 years. Main outcome measures: Diameters of retinal arterioles and venules measured from digitised photographs of the retina taken at baseline. Measurements summarised as the arteriole: venule ratio, with a lower ratio indicating smaller arteriolar diameters. Incident hypertension, defined as systolic blood pressure≥ 140 mm Hg, diastolic blood pressure≥ 90 mm Hg, or use of antihypertensive drugs during follow up. Results: 721 participants developed hypertension over a 10 year period. Those with lower arteriole: venule ratios had a higher cumulative incidence of hypertension (incidences of 17.4% , 24.1% , 31.0% , and 45.1% , respectively, for decreasing quarters of distribution of arteriole:venule ratio). After adjustment for age and sex, participants with arteriole:venule ratios in the lowest quarter had a threefold higher risk of hypertension (odds ratio 2.95, 95% confidence interval 2.77 to 3.88) than those with ratios in the highest quarter. This association remained significant after further adjustment for baseline systolic and diastolic blood pressure and other risk factors (1.82, 1.39 to 2.40, for lowest versus highest ratio quarters). Conclusions: Narrowed retinal arterioles are associated with long term risk of hypertension, suggesting that structural alterations of the microvasculature may be linked to the development of hypertension.展开更多
Objective.-To assess whether migraine is associated with retinal microvascular caliber.Background.-Migraine is believed to be associated with vascular disease,but few studies have investigated the relationship between...Objective.-To assess whether migraine is associated with retinal microvascular caliber.Background.-Migraine is believed to be associated with vascular disease,but few studies have investigated the relationship between structural microvascular changes and migraine.Design.-Population-based cross-sectional study.Methods.-Participants in the Blue Mountains Eye Study follow-up(1997 to 1999,n=2335,aged 54+)had retinal photographs taken.A computer-assisted method was used to measure average retinal arteriolar and venular diameters and calculate the arteriole-to-venule ratio.History of migraine was recorded by interview using International Headache Society criteria(1988).Results.-Subjects giving a history of migraine without aura(n=128)had narrower retinal arterioles than subjects giving a history of migraine with aura(n=182)or subjects with no migraine history(n=1619).After multivariate adjustment,mean retinal arteriolar diameter was 4.3 μ m(95% confidence interval 0.5,8.1)narrower in subjects reporting migraine without aura as compared to subjects with no migraine.Conclusions.Individuals with a history of migraine without aura were more likely to have slightly narrower retinal arteriolar caliber than individuals without migraine.This relationship was not present for migraine with aura.These data support the hypothesis that microvascular disease may be associated with certain types of migraine.展开更多
目的探讨糖尿病视网膜病变(DR)患者餐后2 h血糖(2 h PG)升高对眼底图像中动静脉宽度比(AVR)的影响。方法选取DR患者316例,均行标准75 g口服葡萄糖耐量试验(OGTT)检测空腹血糖(FPG)和餐后2 h PG,根据餐后血糖变化幅度(2 h PG-FPG)将所有...目的探讨糖尿病视网膜病变(DR)患者餐后2 h血糖(2 h PG)升高对眼底图像中动静脉宽度比(AVR)的影响。方法选取DR患者316例,均行标准75 g口服葡萄糖耐量试验(OGTT)检测空腹血糖(FPG)和餐后2 h PG,根据餐后血糖变化幅度(2 h PG-FPG)将所有研究对象按三分位分为3组,低分位组(G1)104例、中分位组(G2)108例及高分位组(G3)104例。测量各组眼底图像中AVR水平,采用Pearson相关性分析和多元线性回归分析DR患者AVR的影响因素。结果 (1)G3组和G2组餐后2 h PG、空腹胰岛素(FIns)、糖化血红蛋白(Hb A1c)及稳态模型评估-胰岛素抵抗指数(HOMA-IR)均高于G1组,且G3组餐后2 h PG和Hb A1c高于G2组;G3组和G2组2 h AVR较G1组降低,G3组较G2组降低(P<0.05),而各组间空腹AVR比较,差异无统计学意义(P>0.05);(2)Pearson相关分析显示,AVR与FPG、餐后2 h PG、Hb A1c、收缩压(SBP)及舒张压(DBP)均呈负相关(P<0.05);(3)多元线性回归分析显示,餐后2 h PG为DR患者AVR的影响因素(P<0.05)。结论餐后2 h PG升高可能会导致AVR降低,对DR患者应动态观察AVR的变化,对判断DR的严重程度具有意义。展开更多
bjective:To examine the relation b etween diameters of the retinal arterioles and 10year in cidence of hyperten-sion.Design:Population based prospective cohort study.Setting:Beaver Dam eye study.Participants:2451nor-m...bjective:To examine the relation b etween diameters of the retinal arterioles and 10year in cidence of hyperten-sion.Design:Population based prospective cohort study.Setting:Beaver Dam eye study.Participants:2451nor-motensive people aged 43to 84years.Main outcome measures:Diameters of retinal arte rioles and venules measured from digitised photographs of the retina taken at baseline.Measurements summarised as the arteriole:venule ratio,with a lower ratio indi cating smaller arteriolar diameters.Incident hypertension,defined as systolic blood pressure≥140mm Hg,diastolic blood pressure≥90mm Hg,or use of antihypertensive d rugs during follow up.Results:721participants developed hypertension over a 10year period.Those with lower arteriole:venule ratios had a higher cumulative incidence of hypertension(incidences of 17.4%,24.1%,31.0%,a nd 45.1%,respectively,for decreasing quarters of distribution of ar-teriole:venule ratio).After adjustment for age and sex,participants with arteriole:venul e ratios in the lowest quarter had a threefold higher risk o f hypertension(odds ratio 2.95,95%confidence interval2.77to 3.88)than those with ratios in the highest quarter.This association remained significant after further adjustment for baseline systolic and diastolic blood pressu re and other risk factors(1.82,1.39to 2.40,for lowest versus highest ratio quarters).Conclusions:Narrowed retinal arterioles are associated with long term risk of hyp ertension,suggestingthat structural alterations of the microvasculature may be linked to the development of hyperte nsion.展开更多
PURPOSE. To describe familial correlations of retinal vessel measurements. METHODS. A standardized examination and interview was administered to a population- based cohort of adults aged 43- 86 years. Blood pressure w...PURPOSE. To describe familial correlations of retinal vessel measurements. METHODS. A standardized examination and interview was administered to a population- based cohort of adults aged 43- 86 years. Blood pressure was measured, and family relationships, current smoking status, and photographs of the retina were obtained. Computer- assisted grading was done to determine central retinal arteriole (CRAE) and venule equivalents (CRVE), and the arteriole- to- venule ratio (AVR)- was computed. Familial correlations were calculated using FCOR in the SAGE software package. Analysis was done on the right eye measures for 871 sibling, 341 parent- child, 1362 cousin, 554 avuncular, and 887 spousal pairs. RESULTS. After adjustment for age, gender, mean arterial blood pressure, and current smoking status, the correlations (and 95% confidence interval) between siblings for the CRVE, CRAE,and AVR were 0.23 (0.16, 0.31), 0.20 (0.12, 0.28) and 0.13 (0.05, 0.20), respectively. Parent- child correlations were very similar, and the avuncular correlations were about half as great. The cousin correlations were about half the avuncular correlations. Spousal correlations of 0.03, 0.04, and 0.01 for CRVE, CRAJE, and AVR, respectively, were not significantly different from 0. CONCLUSIONS. Retinal vessel equivalents were more highly correlated between relatives than between unrelated individuals. The relative magnitudes of these correlations were likely the result of shared genes. Because the vessel measurements have been shown to be predictive of cardiovascular and other systemic diseases, understanding the determinants of these familial relationships could have important health benefits.展开更多
文摘Background: Cerebral and retinal vessels behave similarly under the influence of vascular risk factors. Several groups have shown that retinal microvascular abnormalities represent an independent risk factor with regard to strokes and heart attacks. Aim of the Study: The aim of this study was to perform a prospective screening examinationwith regard to retinalmicrovascular abnormalities as well as an extended vessel diagnosis in a subgroup of patients with lower arteriovenous risk values. Methods: In the course of a prospective cross-sectional study (“Talking Eyes”) between 1.9.2001 and 1.8.2002 a telemedical-supported screening of the retina (study 1) was carried out in 7,163 subjects. The patients were selected without any inclusion or exclusion criteria. The mean age was 48.2±8 years (18-83 years) with a sex distribution of 39.2%females to 60.8%males. Digital fundus photos of the right and left eyes were taken for all patients. The pictures were taken without pupil dilation using a CANON-NM camera. The pictures and case histories were stored in a central server using web-based software (MedStage, Siemens). In a central reading centre, the arteriovenous ratio of both eyes was determined telemedically using the Parr-Hubbard formula and the retinas subjected to a standardised examination by an ophthalmologist. The retinal risk factor was calculated on the basis of the arteriovenous ration, the presence of microvascular abnormalities and the case history. The reproducibility of measurement of the arteriovenous ratio (Kronbach alpha coefficient) was evaluated by double measurements on 1,332 images. In a subgroup of study 1 with arteriovenous ratio values < 0.76 (N=107), an extended vessel diagnosis with measurement of 24-h blood pressure and vessel-relevant blood values (homocysteine, cholesterol, LDL, HDL, CRP, TG, HbA1c) was carried out (study II). Results: Study 1: The Kronbach alpha coefficient as a measure of reproducibility amounted to 0.77. The mean arteriovenous ratio of the retinal vessels was 0.83±0
文摘Obsjective: To examine the relation between diameters of the retinal arterioles and 10 year incidence of hypertension. Design: Population based prospective cohort study. Setting: Beaver Dam eye study. Participants: 2451 normotensive people aged 43 to 84 years. Main outcome measures: Diameters of retinal arterioles and venules measured from digitised photographs of the retina taken at baseline. Measurements summarised as the arteriole: venule ratio, with a lower ratio indicating smaller arteriolar diameters. Incident hypertension, defined as systolic blood pressure≥ 140 mm Hg, diastolic blood pressure≥ 90 mm Hg, or use of antihypertensive drugs during follow up. Results: 721 participants developed hypertension over a 10 year period. Those with lower arteriole: venule ratios had a higher cumulative incidence of hypertension (incidences of 17.4% , 24.1% , 31.0% , and 45.1% , respectively, for decreasing quarters of distribution of arteriole:venule ratio). After adjustment for age and sex, participants with arteriole:venule ratios in the lowest quarter had a threefold higher risk of hypertension (odds ratio 2.95, 95% confidence interval 2.77 to 3.88) than those with ratios in the highest quarter. This association remained significant after further adjustment for baseline systolic and diastolic blood pressure and other risk factors (1.82, 1.39 to 2.40, for lowest versus highest ratio quarters). Conclusions: Narrowed retinal arterioles are associated with long term risk of hypertension, suggesting that structural alterations of the microvasculature may be linked to the development of hypertension.
文摘Objective.-To assess whether migraine is associated with retinal microvascular caliber.Background.-Migraine is believed to be associated with vascular disease,but few studies have investigated the relationship between structural microvascular changes and migraine.Design.-Population-based cross-sectional study.Methods.-Participants in the Blue Mountains Eye Study follow-up(1997 to 1999,n=2335,aged 54+)had retinal photographs taken.A computer-assisted method was used to measure average retinal arteriolar and venular diameters and calculate the arteriole-to-venule ratio.History of migraine was recorded by interview using International Headache Society criteria(1988).Results.-Subjects giving a history of migraine without aura(n=128)had narrower retinal arterioles than subjects giving a history of migraine with aura(n=182)or subjects with no migraine history(n=1619).After multivariate adjustment,mean retinal arteriolar diameter was 4.3 μ m(95% confidence interval 0.5,8.1)narrower in subjects reporting migraine without aura as compared to subjects with no migraine.Conclusions.Individuals with a history of migraine without aura were more likely to have slightly narrower retinal arteriolar caliber than individuals without migraine.This relationship was not present for migraine with aura.These data support the hypothesis that microvascular disease may be associated with certain types of migraine.
文摘目的探讨糖尿病视网膜病变(DR)患者餐后2 h血糖(2 h PG)升高对眼底图像中动静脉宽度比(AVR)的影响。方法选取DR患者316例,均行标准75 g口服葡萄糖耐量试验(OGTT)检测空腹血糖(FPG)和餐后2 h PG,根据餐后血糖变化幅度(2 h PG-FPG)将所有研究对象按三分位分为3组,低分位组(G1)104例、中分位组(G2)108例及高分位组(G3)104例。测量各组眼底图像中AVR水平,采用Pearson相关性分析和多元线性回归分析DR患者AVR的影响因素。结果 (1)G3组和G2组餐后2 h PG、空腹胰岛素(FIns)、糖化血红蛋白(Hb A1c)及稳态模型评估-胰岛素抵抗指数(HOMA-IR)均高于G1组,且G3组餐后2 h PG和Hb A1c高于G2组;G3组和G2组2 h AVR较G1组降低,G3组较G2组降低(P<0.05),而各组间空腹AVR比较,差异无统计学意义(P>0.05);(2)Pearson相关分析显示,AVR与FPG、餐后2 h PG、Hb A1c、收缩压(SBP)及舒张压(DBP)均呈负相关(P<0.05);(3)多元线性回归分析显示,餐后2 h PG为DR患者AVR的影响因素(P<0.05)。结论餐后2 h PG升高可能会导致AVR降低,对DR患者应动态观察AVR的变化,对判断DR的严重程度具有意义。
文摘bjective:To examine the relation b etween diameters of the retinal arterioles and 10year in cidence of hyperten-sion.Design:Population based prospective cohort study.Setting:Beaver Dam eye study.Participants:2451nor-motensive people aged 43to 84years.Main outcome measures:Diameters of retinal arte rioles and venules measured from digitised photographs of the retina taken at baseline.Measurements summarised as the arteriole:venule ratio,with a lower ratio indi cating smaller arteriolar diameters.Incident hypertension,defined as systolic blood pressure≥140mm Hg,diastolic blood pressure≥90mm Hg,or use of antihypertensive d rugs during follow up.Results:721participants developed hypertension over a 10year period.Those with lower arteriole:venule ratios had a higher cumulative incidence of hypertension(incidences of 17.4%,24.1%,31.0%,a nd 45.1%,respectively,for decreasing quarters of distribution of ar-teriole:venule ratio).After adjustment for age and sex,participants with arteriole:venul e ratios in the lowest quarter had a threefold higher risk o f hypertension(odds ratio 2.95,95%confidence interval2.77to 3.88)than those with ratios in the highest quarter.This association remained significant after further adjustment for baseline systolic and diastolic blood pressu re and other risk factors(1.82,1.39to 2.40,for lowest versus highest ratio quarters).Conclusions:Narrowed retinal arterioles are associated with long term risk of hyp ertension,suggestingthat structural alterations of the microvasculature may be linked to the development of hyperte nsion.
文摘PURPOSE. To describe familial correlations of retinal vessel measurements. METHODS. A standardized examination and interview was administered to a population- based cohort of adults aged 43- 86 years. Blood pressure was measured, and family relationships, current smoking status, and photographs of the retina were obtained. Computer- assisted grading was done to determine central retinal arteriole (CRAE) and venule equivalents (CRVE), and the arteriole- to- venule ratio (AVR)- was computed. Familial correlations were calculated using FCOR in the SAGE software package. Analysis was done on the right eye measures for 871 sibling, 341 parent- child, 1362 cousin, 554 avuncular, and 887 spousal pairs. RESULTS. After adjustment for age, gender, mean arterial blood pressure, and current smoking status, the correlations (and 95% confidence interval) between siblings for the CRVE, CRAE,and AVR were 0.23 (0.16, 0.31), 0.20 (0.12, 0.28) and 0.13 (0.05, 0.20), respectively. Parent- child correlations were very similar, and the avuncular correlations were about half as great. The cousin correlations were about half the avuncular correlations. Spousal correlations of 0.03, 0.04, and 0.01 for CRVE, CRAJE, and AVR, respectively, were not significantly different from 0. CONCLUSIONS. Retinal vessel equivalents were more highly correlated between relatives than between unrelated individuals. The relative magnitudes of these correlations were likely the result of shared genes. Because the vessel measurements have been shown to be predictive of cardiovascular and other systemic diseases, understanding the determinants of these familial relationships could have important health benefits.
