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Three-year incidence and cumulative prevalence of retinopathy: the atherosclerosis risk in communities study.

TitleThree-year incidence and cumulative prevalence of retinopathy: the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2007
AuthorsWong TY, Klein R, Amirul Islam FM, Cotch M F, Couper DJ, Klein BEK, Hubbard LD, A Sharrett R
JournalAm J Ophthalmol
Volume143
Issue6
Pagination970-6
Date Published2007 Jun
ISSN0002-9394
KeywordsAged, Atherosclerosis, Blood Glucose, Blood Pressure, Cholesterol, Cohort Studies, Female, Fibrinogen, Humans, Hyperglycemia, Hypertension, Incidence, Male, Middle Aged, Photography, Prevalence, Prospective Studies, Retinal Diseases, Risk Factors, United States
Abstract

PURPOSE: To describe the three-year incidence and cumulative prevalence of retinopathy and its risk factors.

DESIGN: Population-based, prospective cohort study in four US communities.

METHODS: In the Atherosclerosis Risk in Communities (ARIC) Study, 981 participants had retinal photography of one randomly selected eye at the third examination (1993 to 1995) and three years later at the fourth examination (1996). Photographs were graded on both occasions for retinopathy signs (for example, microaneurysm, retinal hemorrhage, and/or cotton-wool spots). Incidence was defined as participants without retinopathy at the third examination who developed retinopathy at the fourth examination, and cumulative prevalence was defined to include incident retinopathy as well as participants who had retinopathy at both the third and fourth examinations.

RESULTS: The three-year incidence and cumulative prevalence of any retinopathy in the whole cohort was 3.8% and 7.7%, respectively. In multivariable analysis, incident retinopathy was related to higher mean arterial blood pressure (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.0 to 2.3, per standard deviation increase in risk factor levels), fasting serum glucose (OR 1.6, 95% CI 1.3 to 2.1), serum total cholesterol (OR 1.4, 95% CI 1.0, 2.0), and plasma fibrinogen (OR 1.4, 95% CI 1.1 to 1.9). Among persons without diabetes, the three-year incidence and cumulative prevalence of nondiabetic retinopathy was 2.9% and 4.3%, respectively. Incident nondiabetic retinopathy was related to higher mean arterial blood pressure (OR 1.4, 95% CI 0.9 to 2.3) and fasting serum glucose (OR 1.5, 95% CI 1.0 to 2.3). Among persons with diabetes, the three-year incidence and cumulative prevalence of diabetic retinopathy was 10.1% and 27.2%, respectively.

CONCLUSIONS: Retinopathy signs occur frequently in middle-aged people, even in those without diabetes. Hypertension and hyperglycemia are risk factors for incident retinopathy.

DOI10.1016/j.ajo.2007.02.020
Alternate JournalAm J Ophthalmol
PubMed ID17399675
PubMed Central IDPMC1950734
Grant ListR03 EY013939-01 / EY / NEI NIH HHS / United States
ZIA EY000426-10 / / Intramural NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
Z99 EY999999 / / Intramural NIH HHS / United States
N01-HC-35126 / HC / NHLBI NIH HHS / United States
ZIA EY000426-07 / / Intramural NIH HHS / United States
Z01 EY000426-04 / / Intramural NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
ZIA EY000426-06 / / Intramural NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-35125 / HC / NHLBI NIH HHS / United States
ZIA EY000426-13 / / Intramural NIH HHS / United States
R03 EY013939-02 / EY / NEI NIH HHS / United States
ZIA EY000426-09 / / Intramural NIH HHS / United States
Z01 EY000426-05 / / Intramural NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
ZIA EY000426-11 / / Intramural NIH HHS / United States
ZIA EY000426-08 / / Intramural NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
ZIA EY000426-12 / / Intramural NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01HC55020 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States