title: 15-year cumulative incidence and associated risk factors for retinopathy in nondiabetic persons.
abstract: OBJECTIVE
  To investigate the relationship of systemic factors to the 15-year cumulative incidence of retinopathy in nondiabetic persons in the Beaver Dam Eye Study.
  
  
  METHODS
  Included were 4699 persons, 43 to 86 years of age at baseline examination in 1988-1990 and with follow-up in 1993-1995 and/or 1998-2000 and/or 2003-2005. Stereoscopic color fundus photographs were graded to determine the presence of retinopathy. The main outcome measure was cumulative incidence of retinopathy accounting for competing risk of death or diabetes mellitus.
  
  
  RESULTS
  The 15-year cumulative incidence of retinopathy in the nondiabetic cohort was 14.2%. In multivariate analyses, older age (hazard ratio [HR] per age group, 1.13; 95% confidence interval [CI], 1.01-1.27), higher systolic blood pressure (HR per 10 mm Hg, 1.15; 95% CI, 1.07-1.20), presence of chronic kidney disease (HR, 1.51; 95% CI, 1.12-2.00), and wider retinal arteriolar diameter (HR per 10 μm, 1.17; 95% CI, 1.10-1.26) at baseline were associated with the incidence of retinopathy. In a separate model, the 15-year incidence of retinopathy was higher in those with uncontrolled hypertension compared with those who did not have hypertension (HR, 2.07; 95% CI, 1.51-2.83). There were no associations of body mass index, lipid levels, glycosylated hemoglobin level, smoking status, markers of inflammation, endothelial dysfunction and oxidative stress, and hematologic factors with retinopathy incidence.
  
  
  CONCLUSIONS
  These data show 2 modifiable factors, uncontrolled hypertension and chronic kidney disease, are related to an increased incidence of retinopathy in nondiabetic persons and show that control of blood pressure is associated with a lower risk of incident retinopathy compared with uncontrolled blood pressure.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, 53726, USA. kleinr@epi.ophth.wisc.edu
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Chelsea E
authors.initials: CE
authors.lastname: Myers
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Lee
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010781:Photography; D012161:Retinal Artery / Q000473:pathology; D012164:Retinal Diseases / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D014922:Wisconsin / Q000453:epidemiology