title: Evidence of early retinal microvascular changes in patients with type 2 diabetes and depression.
abstract: OBJECTIVE
  To examine retinal vascular caliber, an indicator of early microvascular disease and depression in patients with Type 2 diabetes.
  
  
  METHODS
  We conducted a clinic-based study, comparing participants with Type 2 diabetes with major depression (n = 43), without depression (n = 49), and healthy controls without diabetes or depression (n = 54). Retinal vascular caliber was measured from digital photographs. Depression status was determined, using standardized clinical assessment.
  
  
  RESULTS
  After adjusting for age and gender, participants with diabetes and depression had larger arteriolar and venular calibers (147.7 microm for arteriolar and 215.7 microm for venular calibers) than participants with diabetes but without depression (143.3 microm and 213.9 microm) and healthy controls (135.8 microm and 202.5 microm, p for trend = .002 for arteriolar and p = .02 for venular caliber). In multivariate models adjusting for duration of diabetes, systolic blood pressure, cigarette smoking, serum glucose, Cerebrovascular Risk Factor Scale, Cumulative Illness Rating Scale, and retinopathy levels, this relationship remained significant for retinal arterioles (p = .02) but not for retinal venules (p = .10).
  
  
  CONCLUSIONS
  These data show that patients with Type 2 diabetes with major depression have wider retinal arterioles, supporting the concept that depression is associated with early microvascular changes in Type 2 diabetes.
authors.affiliation: Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, Victoria 3002, Australia. bittet@yahoo.com
authors.forename: Thanh Tan
authors.initials: TT
authors.lastname: Nguyen
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.forename: F M Amirul
authors.initials: FM
authors.lastname: Islam
authors.forename: Larry
authors.initials: L
authors.lastname: Hubbard
authors.forename: Olusola
authors.initials: O
authors.lastname: Ajilore
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Haroon
authors.forename: Christine
authors.initials: C
authors.lastname: Darwin
authors.forename: Barbara
authors.initials: B
authors.lastname: Esser
authors.forename: Anand
authors.initials: A
authors.lastname: Kumar
mesh_terms: D001160:Arterioles / Q000473:pathology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000473:pathology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D012161:Retinal Artery / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology*; D012307:Risk Factors; D014699:Venules / Q000473:pathology