Retinal vascular abnormalities in persons with type 1 diabetes: the Wisconsin Epidemiologic Study of Diabetic Retinopathy: XVIII.
OBJECTIVE
To describe the distribution of retinal vascular characteristics and their correlates in people with type 1 diabetes.


METHODS
Population-based study with baseline cross-sectional findings.


METHODS
Nine hundred ninety-six persons who were diagnosed with diabetes before 30 years of age and who were taking insulin in an 11-county area in south-central Wisconsin participated in the baseline examination from 1980 to 1982. In addition, 225 persons without diabetes participated.


METHODS
Retinal photographs of 7 standard fields were taken; lightbox grading was performed to determine arteriovenous (A/V) nicking and focal retinal arteriolar narrowing. Computer-assisted grading was performed from a digitized image of field 1 to determine central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and the arteriole-to-venule ratio (AVR).


METHODS
Frequency and distribution of A/V nicking, CRAE, CRVE, AVR, and focal retinal arteriolar narrowing.


RESULTS
In multivariate analyses, retinopathy severity, mean arterial blood pressure, presence of gross proteinuria, glycosylated hemoglobin, and history of cardiovascular disease were associated with CRAE. Retinopathy severity, age, mean arterial blood pressure, duration of diabetes, glycosylated hemoglobin level, and body mass index were associated with CRVE. With the exception of glycosylated hemoglobin, similar factors were associated with AVR. Age (odds ratio [OR] per 10 years, 2.43 and 2.02) and retinopathy severity (OR per level, 1.14 and 1.21) were associated with focal retinal arteriolar narrowing and A/V nicking, respectively. In persons >/=18 years of age, smoking was associated with CRAE, CRVE, and A/V nicking (OR, 2.67), but not with AVR or focal arteriolar narrowing.


CONCLUSIONS
This study documented the frequency and distribution of retinal vascular characteristics and their relationships to various factors in persons with type 1 diabetes.
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin 53726, USA. kleinr@epi.ophth.wisc.edu
Ronald
R
Klein
Barbara E K
BE
Klein
Scot E
SE
Moss
Tien Y
TY
Wong
Larry
L
Hubbard
Karen J
KJ
Cruickshanks
Mari
M
Palta
D000328:Adult; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D011507:Proteinuria / Q000175:diagnosis; D012161:Retinal Artery / Q000473:pathology*; D012169:Retinal Vein / Q000473:pathology*; D012307:Risk Factors; D014922:Wisconsin / Q000453:epidemiology
D006442:Glycated Hemoglobin