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Abstract
To evaluate the association between a series of retinal information and cardiovascular disease (CVD) and to evaluate whether this association is independent of traditional CVD risk factors in type 2 diabetes patients, we undertook an age-sex matched case-control study with 79 CVD cases and 150 non-CVD controls. All the participants underwent standardized physical examinations and retinal imaging. Retinal information was extracted from the retinal images using a semi-automatic computer program. Three stepwise logistic regression models were evaluated: model 1 with cardiovascular risk factors only; model 2 with retinal information only and model 3 with both cardiovascular risk factors and retinal information. The areas under the receiver operating characteristic curves (AUCs) were used to compare the performances of different models. Results showed that the AUCs were 0.692 (95%CI: 0.622−0.761) and 0.661 (95%CI: 0.588−0.735) for model 1 and model 2, respectively. In addition, model 3 had an AUC of 0.775 (95%CI: 0.716−0.834). Compared to the previous two models, the AUC of model 3 increased significantly (p < 0.05 in both comparisons). In conclusion, retinal information is independently associated with CVD in type 2 diabetes. Further work is needed to validate the translational value of applying retinal imaging analysis into clinical practice.
Highlights
Retinal vessels are the only vessels that can be directly seen in the human body and provide rich information, including vascular diameter, attenuation, geometry at the branching and measures reflecting how effectively the vascular network fills the retinal space
Most studies investigating the association between retinal vascular parameters and cardiovascular disease (CVD) were conducted in the general population[7,8,9,10,11], rather than diabetic patients[12,13,14,15], a group with higher risk of developing CVD (2− 5 times) than the general population due to the clustering of risk factors[16]
In this study, we attempt to assess the association between a spectrum of retinal information and CVD among type 2 diabetes patients, and evaluate whether this association is independent of traditional cardiovascular risk factors
Summary
Retinal vessels are the only vessels that can be directly seen in the human body and provide rich information, including vascular diameter, attenuation, geometry at the branching and measures reflecting how effectively the vascular network fills the retinal space. Most studies investigating the association between retinal vascular parameters and CVD were conducted in the general population[7,8,9,10,11], rather than diabetic patients[12,13,14,15], a group with higher risk of developing CVD (2− 5 times) than the general population due to the clustering of risk factors[16]. In this study, we attempt to assess the association between a spectrum of retinal information and CVD among type 2 diabetes patients, and evaluate whether this association is independent of traditional cardiovascular risk factors. Our findings should add fuel to the ongoing research on the association between retinal microvascular characteristics and cardiovascular risk
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