Original article
Retinal Vascular Caliber and Age-related Macular Degeneration: The Singapore Malay Eye Study

https://doi.org/10.1016/j.ajo.2008.07.006Get rights and content

Purpose

To investigate the relationship between retinal vascular caliber and age-related macular degeneration (AMD).

Design

Population-based cross-sectional study.

Methods

Three thousand two hundred and eighty (78.7% response rate) Malay Singaporeans aged 40 to 80 years residing in 15 districts of Singapore underwent retinal photography. Retinal vessel caliber was measured from retinal photographs using a validated computer-based technique. AMD was assessed following a modified Wisconsin Age-Related Maculopathy Grading System.

Results

Retinal data were available from 3,265 subjects (99.5% of 3,280) for this study. Early and late AMD prevalence were 4.9% (n = 160) and 0.7% (n = 23) of the population, respectively, or in 205 (3.1%) and 30 (0.5%) eyes examined, respectively. After controlling for age and arteriolar caliber, wider venular caliber was associated with higher prevalence of early AMD (odds ratio [OR] per one standard deviation [SD] increment in venular caliber, 1.53; 95% confidence interval [CI], 1.13 to 2.09). This association remained significant after further adjustment for gender, smoking, hypertension, diabetes, and body mass index (OR per one SD, 1.52; 95% CI, 1.11 to 2.09). There was no significant association between retinal arteriolar caliber and early AMD, or between arteriolar or venular caliber and late AMD.

Conclusions

Wider venular caliber was associated independently with early AMD. This finding may suggest that pathogenic processes linking to wider venular caliber be shared by early AMD and common cardiovascular risk factors such as inflammation, dyslipidemia, and endothelial dysfunction.

Section snippets

Methods

The Singapore Malay Eye Study is a population-based cross-sectional survey of eye diseases in urban Malay adults ranging in age between 40 and 80 years residing in 15 districts in Southwestern Singapore.22 Subjects were selected, using an age-stratified (by 10-year age group) random sampling method, from a computer-generated list provided by the Singapore Ministry of Home Affairs. Of 4,168 eligible participants, 3,280 (78.7%) participated in the study, conducted from August 2004 through June

Results

Early and late AMD was present in 160 (4.9%) and 23 (0.07%) of the study subjects and in 205 (3.1%) and 30 (0.05%) of the eyes examined, respectively. Table 1 shows the demographic characteristics, subcategorized by the presence of early or late AMD. The mean CRAE in eyes without AMD, with early AMD, and with late AMD was 139.6 μm, 139.0 μm, and 137.5 μm, respectively. The mean CRVE in eyes without AMD, with early AMD, and with and late was 219.2 μm, 221.9 μm, and 213.8 μm, respectively.

Table 2

Discussion

We found that wider retinal venular caliber was associated significantly with retinal pigmentary abnormalities and early AMD after controlling for age, gender, smoking, hypertension, diabetes, and BMI. Although there was an association between narrower retinal arteriolar caliber and retinal pigmentary abnormalities, there was no significant association between retinal arteriolar caliber and early AMD. We could not find significant associations between arteriolar or venular caliber and late AMD.

Dr V. Swetha E. Jeganathan is from the Centre of Eye Research Australia and is currently attached as a clinical research fellow at the Singapore Eye Research Institute. Since graduating from medicine at Monash University, Australia, she attained her Masters of Applied Management, majoring in Public Health at the University of Newcastle, Australia, and is currently working toward a MD and Doctorate in International Ophthalmology.

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Dr V. Swetha E. Jeganathan is from the Centre of Eye Research Australia and is currently attached as a clinical research fellow at the Singapore Eye Research Institute. Since graduating from medicine at Monash University, Australia, she attained her Masters of Applied Management, majoring in Public Health at the University of Newcastle, Australia, and is currently working toward a MD and Doctorate in International Ophthalmology.

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