Retinal and cerebral microvascular signs and diabetes: the age, gene/environment susceptibility-Reykjavik study.
OBJECTIVE
Diabetes increases the risk for microvascular disease. The retina and the brain both have intricate microvascular systems that are developmentally similar. We sought to examine whether microvascular lesions in the retina and in the brain are associated and whether this association differs among people with and without diabetes.


METHODS
The analysis included 4,218 participants of the Icelandic population-based Age, Gene/Environment Susceptibility-Reykjavik Study who were born in 1907-1935 and who were previously followed as a part of the Reykjavik Study. Retinal focal arteriolar narrowing, arteriovenous (AV) nicking, and microaneurysms/hemorrhages were evaluated on digital retinal images of both eyes. Cerebral microbleeds (CMBs) were evaluated from magnetic resonance images. Data were analyzed with logistic and multinomial logistic regression models controlling for demographics, major cardiovascular risk factors, cerebral infarcts, and white matter lesions.


RESULTS
Evidence of brain microbleeds was found in 485 (11.5%) people, including 192 with multiple (>or=2) microbleeds. Subjects with signs of retinal microvascular lesions were at a significantly increased likelihood for having multiple CMBs. People with diabetes in combination with the presence of either retinal AV nicking (odds ratio [OR] 2.47 [95% CI 1.42-4.31]) or retinal microaneurysms/hemorrhages (2.28 [1.24-4.18]) were significantly more likely to have multiple CMBs.


CONCLUSIONS
Retinal microvascular abnormalities and brain microbleeds may occur together in older adults. People with both diabetes and signs of retinal microvascular lesions (AV nicking and microaneurysms/hemorrhages) are more likely to have multiple microbleeds in the brain. Microvascular disease in diabetes extends to the brain.
Qiu
Chengxuan
C
Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health (NIH), Bethesda, Maryland 20892, USA.
Cotch
Mary Frances
MF
Sigurdsson
Sigurdur
S
Garcia
Melissa
M
Klein
Ronald
R
Jonasson
Fridbert
F
Klein
Barbara E K
BE
Eiriksdottir
Gudny
G
Harris
Tamara B
TB
van Buchem
Mark A
MA
Gudnason
Vilmundur
V
Launer
Lenore J
LJ
D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003920:Diabetes Mellitus / Q000235:genetics* / Q000503:physiopathology*; D004777:Environment; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007055:Iceland; D008279:Magnetic Resonance Imaging; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D012160:Retina / Q000503:physiopathology*; D012171:Retinal Vessels / Q000503:physiopathology*; D014699:Venules / Q000503:physiopathology