Purpose: To examine the relationship between open- angle glaucoma (OAG) and retinal vessel diameter among baseline participants in the Blue Mountains Eye Study. Design: Population- based cross- sectional study. Partic...Purpose: To examine the relationship between open- angle glaucoma (OAG) and retinal vessel diameter among baseline participants in the Blue Mountains Eye Study. Design: Population- based cross- sectional study. Participants: The study included 3654 persons older than49 years, representing 82.4% of permanent residents living in an area west of Sydney. Methods:Participants had a detailed eye examination, including automated perimetry and stereo optic disc photography. A computer- assisted program measured retinal vessel diameters from digitized photographs of right eyes. Main Outcome Measures: Open- angle glaucomawas diagnosed frommatching visual field defects and optic disc cupping, without reference to intraocular pressure (IOP) level. Ocular hypertension was defined as IOP of >21 mmHg in either eye, without matching glaucomatous optic disc and field changes. Average retinal vessel diameters, measured from right eyes, were summarized as arteriolar and venular equivalents. The lowest quintile of the arteriolar equivalent or arteriole- to- venule ratio was used to define generalized retinal arteriolar narrowing. Results: The study included 3314 participants, after excluding those with incomplete data or nonglaucomatous optic nerve disease. Of persons included,59 (1.8% ) had evidence of glaucomatous damage affecting the right eye, 3065 (92.5% ) had no damage to either eye, and 163 (4.9% ) had ocular hypertension. Right eyes with glaucomatous damage had significantly narrower retinal arteriolar diameters (183± 2.6 μ m) than eyes without glaucoma (194± 0.4 μ m, P= 0.0001) or eyes with ocular hypertension (195± 1.6 μ m, P= 0.0002), after adjusting for age, mean arterial blood pressure, and other confounding variables, including refraction. Right eyes with glaucomatous damage were at least 2 times more likely to have generalized retinal arteriolar narrowing than eyes without glaucoma (odds ratio, 2.7; 95% confidence interval, 1.5- 4.8). Conclusions: These population- based data suggest that generalized retinal arteriolar narrowing, an indicator of localized vascular change, is significantly associated with optic nerve damage caused by OAG. It is not clear whether such a retinal arteriolar change reflects an ischemic process leading to optic nerve damage or results from loss of retinal neurons secondary to glaucoma.展开更多
Objective: To examine the effects of current and past blood pressure on retina l arteriolar diameter in a general older population. Design: Cross-sectional an d longitudinal studies. Setting: Population-based cohort s...Objective: To examine the effects of current and past blood pressure on retina l arteriolar diameter in a general older population. Design: Cross-sectional an d longitudinal studies. Setting: Population-based cohort study of older residen ts from an area west of Sydney, Australia. Participants: Two thousand three hund red and thirty-five individuals (n=2335) (aged≥54 years) who attended the 5-y ear follow-up Blue Mountains Eye Study during 1997-99. Main outcome measures: A computer-assisted method measured vessel diameters from digitized right eye r etinal photographs. The narrowest quintile of central retinal arteriolar equival ent or arteriole-to-venule ratio (AVR) defined generalized arteriolar narrowin g. Blood pressure was measured using a mercury sphygmomanometer. Results: After simultaneous adjustment for age, sex, body mass index, smoking and current or pa st blood pressure, elevated levels of both current and past blood pressure were associated with narrower retinal arterioles <<Ptrend=0.009 and 0.007 for current and past systolic blood pressure (SBP), respectively>> and lower AVR <<Ptrend= 0.0 01 and 0.0009 for current and past diastolic blood pressure (DBP), respectively>> . Generalized arteriolar narrowing was associated with both current blood pressu re <<adjusted odds ratio (OR) 2.4, 95%confidence interval (CI) 1.5-3.8 for the highest versus lowest quintile of current DBP>> and past blood pressure (adjusted OR 1.7, 95%CI 1.1-2.6, for the highest versus lowest quintile of past DBP). H ypertension duration or control status at baseline had no additional effect on a rteriolar diameter after adjusting for current blood pressure. Conclusions: Our data document the independent effects of both current and past blood pressure on small vessel calibre in the retina, suggesting that retinal arteriolar narrowin g may result from the cumulative effects of long-standing hypertension.展开更多
文摘Purpose: To examine the relationship between open- angle glaucoma (OAG) and retinal vessel diameter among baseline participants in the Blue Mountains Eye Study. Design: Population- based cross- sectional study. Participants: The study included 3654 persons older than49 years, representing 82.4% of permanent residents living in an area west of Sydney. Methods:Participants had a detailed eye examination, including automated perimetry and stereo optic disc photography. A computer- assisted program measured retinal vessel diameters from digitized photographs of right eyes. Main Outcome Measures: Open- angle glaucomawas diagnosed frommatching visual field defects and optic disc cupping, without reference to intraocular pressure (IOP) level. Ocular hypertension was defined as IOP of >21 mmHg in either eye, without matching glaucomatous optic disc and field changes. Average retinal vessel diameters, measured from right eyes, were summarized as arteriolar and venular equivalents. The lowest quintile of the arteriolar equivalent or arteriole- to- venule ratio was used to define generalized retinal arteriolar narrowing. Results: The study included 3314 participants, after excluding those with incomplete data or nonglaucomatous optic nerve disease. Of persons included,59 (1.8% ) had evidence of glaucomatous damage affecting the right eye, 3065 (92.5% ) had no damage to either eye, and 163 (4.9% ) had ocular hypertension. Right eyes with glaucomatous damage had significantly narrower retinal arteriolar diameters (183± 2.6 μ m) than eyes without glaucoma (194± 0.4 μ m, P= 0.0001) or eyes with ocular hypertension (195± 1.6 μ m, P= 0.0002), after adjusting for age, mean arterial blood pressure, and other confounding variables, including refraction. Right eyes with glaucomatous damage were at least 2 times more likely to have generalized retinal arteriolar narrowing than eyes without glaucoma (odds ratio, 2.7; 95% confidence interval, 1.5- 4.8). Conclusions: These population- based data suggest that generalized retinal arteriolar narrowing, an indicator of localized vascular change, is significantly associated with optic nerve damage caused by OAG. It is not clear whether such a retinal arteriolar change reflects an ischemic process leading to optic nerve damage or results from loss of retinal neurons secondary to glaucoma.
文摘Objective: To examine the effects of current and past blood pressure on retina l arteriolar diameter in a general older population. Design: Cross-sectional an d longitudinal studies. Setting: Population-based cohort study of older residen ts from an area west of Sydney, Australia. Participants: Two thousand three hund red and thirty-five individuals (n=2335) (aged≥54 years) who attended the 5-y ear follow-up Blue Mountains Eye Study during 1997-99. Main outcome measures: A computer-assisted method measured vessel diameters from digitized right eye r etinal photographs. The narrowest quintile of central retinal arteriolar equival ent or arteriole-to-venule ratio (AVR) defined generalized arteriolar narrowin g. Blood pressure was measured using a mercury sphygmomanometer. Results: After simultaneous adjustment for age, sex, body mass index, smoking and current or pa st blood pressure, elevated levels of both current and past blood pressure were associated with narrower retinal arterioles <<Ptrend=0.009 and 0.007 for current and past systolic blood pressure (SBP), respectively>> and lower AVR <<Ptrend= 0.0 01 and 0.0009 for current and past diastolic blood pressure (DBP), respectively>> . Generalized arteriolar narrowing was associated with both current blood pressu re <<adjusted odds ratio (OR) 2.4, 95%confidence interval (CI) 1.5-3.8 for the highest versus lowest quintile of current DBP>> and past blood pressure (adjusted OR 1.7, 95%CI 1.1-2.6, for the highest versus lowest quintile of past DBP). H ypertension duration or control status at baseline had no additional effect on a rteriolar diameter after adjusting for current blood pressure. Conclusions: Our data document the independent effects of both current and past blood pressure on small vessel calibre in the retina, suggesting that retinal arteriolar narrowin g may result from the cumulative effects of long-standing hypertension.
