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Background/Aims: In persons with diabetes, retinal microvascular abnormalities are associated with chronic kidney disease (CKD). However, it is not clear if the same relationship applies in persons without diabetes. Methods: We examined 2,971 participants from a population-based study (240 with, 2,731 without diabetes). Retinal photographs were masked graded for retinal microvascular signs, and CKD was defined as estimated glomerular filtration rate (eGFRMDRD) <60 ml/min/1.73 m2. Results: Retinal microvascular signs were more frequent in persons with CKD. After adjusting for age, gender, systolic blood pressure and fasting plasma glucose, CKD was associated with both presence of retinopathy (odds ratio, OR, 1.2, 95% confidence interval, CI 1.0–1.5) and venular dilation (OR 1.2, 95% CI 1.0–1.5). These associations were similar in persons with and without diabetes. There was a significant trend for increasing magnitude of associations of retinopathy with increasing severity levels of CKD (p for trend 0.03). Conclusions: Retinal microvascular signs, namely retinopathy lesions and venular dilation, are associated with CKD both in persons with, and without diabetes. This supports the concept that retinal microvascular signs are indicators of generalized microvascular disease even in the absence of diabetes, and reinforces the link between retinal and renal microcirculations. [ABSTRACT FROM AUTHOR]

The authors assessed associations between retinal vascular signs and incident severe hypertension in an older population-based cohort. At baseline (1992-1994), 3,654 residents aged 49-97 years living in the Blue Mountains area west of Sydney, Australia, were examined; respectively, 2,335 (75.1%) and 1,952 (76%) survivors were reexamined 5 and 10 years later. Retinal arteriolar and venular calibers were measured, and average central retinal artery and central retinal vein equivalents for that eye were estimated. Severe hypertension was defined by previous diagnosis of hypertension plus antihypertensive medication use or by systolic blood pressure > or =160 mmHg and/or diastolic blood pressure > or =100 mmHg at examinations. Of the 1,424 participants at risk, 618 developed severe hypertension over 10 years (cumulative incidence = 47.7%, 95% confidence interval: 44.9, 50.5). Participants who subsequently developed severe hypertension had significantly narrower mean central retinal artery equivalents than those who did not (187.0 vs. 191.9 mum, p < 0.0001). After adjusting for age, sex, body mass index, smoking, mean arterial blood pressure, and plasma glucose and triglyceride levels, baseline narrowing central retinal artery equivalent was associated with increased risk of severe hypertension (per standard deviation reduction, odds ratio = 1.1, 95% confidence interval: 1.1, 1.2; narrowest vs. widest quintile, odds ratio = 1.6, 95% confidence interval: 1.2, 2.1). These findings support structural narrowing in small arteries and arterioles antecedent to clinical onset of severe hypertension. [ABSTRACT FROM AUTHOR]

Purpose: Low birth weight has been suggested as a risk factor for diabetes. Whether it is related to diabetic retinopathy is unclear and is examined in this study. Materials and Methods: We examined 609 adults with type 2 diabetes from the population-based Atherosclerosis Risk in Communities Study. Retinal photographs were graded for diabetic retinopathy. Birth weight was assessed by self-report. Results: Retinopathy was present in 116 (19%) participants (113 non-proliferative and 3 proliferative). After adjusting for age, sex, race, education level, body mass index, fasting glucose, duration of diabetes, glycosylated hemoglobin A1c, family history of diabetes, serum total cholesterol, and blood pressure, there was no evidence of either a linear or non-linear relationship between birthweight and diabetic retinopathy. Conclusions: Birth weight was not associated with diabetic retinopathy. [ABSTRACT FROM AUTHOR]

PurposeTo assess the 5-year incidence of vascular retinopathy and its associations in an older nondiabetic population.MethodsThe Blue Mountains Eye Study examined 3654 residents aged 49+ years (82.4% response rate) during 1992–1994, and re-examined 2335 (75.1% of survivors) during 1997–1999. Retinopathy lesions (microaneurysms, haemorrhages, hard or soft exudates) were assessed from 6-field retinal photographs in persons without diabetes. Incident retinopathy was assessed in those at risk. Hypertensive status was defined following the WHO/International Society of Hypertension guidelines.ResultsOf the 2335 re-examined, 195 had retinopathy lesions at baseline and 1725 were at risk of retinopathy after excluding subjects with diabetes (n=261), retinal vein occlusion (n=52) or missing/un-gradable photographs (n=102). The cumulative 5-year incidence was 9.7% (95% confidence intervals (CI) 8.3–11.1%). Age was the only factor significantly associated with incident retinopathy (Pfor trend=0.012). Neither fasting blood glucose (age–sex-adjusted P=0.147) nor hypertension (adjusted Pfor trend=0.43) was associated with incident retinopathy. Of the 195 with retinopathy lesions at baseline, 3.5% developed diabetes, 13.3% progressed, and 72.3% regressed/disappeared over 5 years. Progression was positively associated with elevated blood pressure (BP) (adjusted odds ratio (OR) 1.3, 95% CI 1.1–1.6 per 10 mmHg systolic BP) and inversely associated with fasting glucose level (OR 0.36, CI 0.14–0.92 per mmol/l increase). Aspirin use was weakly associated with regression (OR 2.4, CI 1.0–6.0).ConclusionsOver 5 years, retinopathy developed in 10% of older people without diabetes, while 72% of baseline lesions regressed. Age was significantly associated with the development of these lesions.Eye (2006) 20, 1239–1245. doi:10.1038/sj.eye.6702085; published online 16 September 2005 [ABSTRACT FROM AUTHOR]

ObjectivesTo describe the epidemiology of pterygium among residents of an island in Indonesia and to examine the roles of age and gender as determinants of bilaterality and severity of the disease.MethodsVoluntary eye screening on Pulau Jaloh, Riau Archipelago, Indonesia. Gender difference was tested using the χ2 test. The difference in age between subjects with and without disease was tested using unpaired Student's t-test. Odds ratio (relative risk) for gender was calculated using logistic regression model with adjustment for age.ResultsOf the 550 inhabitants, 477 (86.7%) responded to the eye screening. The overall prevalence rate of pterygium was 17.0%. Out of 211, 48 male (22.7%) and 33 out of 266 female subjects (12.4%) had the disorder, with the gender difference being statistically significant. Adjusted for age, the risk of disease was 3.1-fold higher among the males. In all, 71.6% of subjects with pterygium had bilateral disease. Subjects with pterygium were significantly older, their mean age being 42.9 years compared to 18.7 years among those without disease. The prevalence rates in male subjects increased from age 20 to reach a plateau of 63.6% at age 35 and remained stable thereafter. In the female subjects, the rates also increased with age, albeit at a slower rate, from age 20 to reach a plateau of 46.7% at age 55 and remained stable thereafter.ConclusionsThere is a high prevalence rate of pterygium among the study subjects, with the rates increasing rapidly with age.Eye (2006) 20, 908–912. doi:10.1038/sj.eye.6702046; published online 16 September 2005 [ABSTRACT FROM AUTHOR]