Retinal vascular caliber and age-related macular degeneration: the Singapore Malay Eye Study.

Abstract

To investigate the relationship between retinal vascular caliber and age-related macular degeneration (AMD). Population-based cross-sectional study. 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. 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. 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.