Three-Year Incidence and Cumulative Prevalence of Retinopathy: The Atherosclerosis Risk in Communities Study

Wong, Tien Y.; Klein, Ronald; Amirul Islam, F.M.; Cotch, Mary Frances; Couper, David J.; Klein, Barbara E.K.; Hubbard, Larry D.; Sharrett, A. Richey

doi:10.1016/j.ajo.2007.02.020

« Previous Next »American Journal of Ophthalmology
Volume 143, Issue 6 , Pages 970-976, June 2007

Three-Year Incidence and Cumulative Prevalence of Retinopathy: The Atherosclerosis Risk in Communities Study

Tien Y. Wong
- Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
- Singapore Eye Research Institute, National University of Singapore, Singapore
- Inquiries to Tien Y. Wong, Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, Victoria 3002, Australia
Ronald Klein
- Department of Ophthalmology and Visual Science, University of Wisconsin, Madison, Wisconsin
F.M. Amirul Islam
- Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
Mary Frances Cotch
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
David J. Couper
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
Barbara E.K. Klein
- Department of Ophthalmology and Visual Science, University of Wisconsin, Madison, Wisconsin
Larry D. Hubbard
- Department of Ophthalmology and Visual Science, University of Wisconsin, Madison, Wisconsin
A. Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Accepted 7 February 2007. published online 13 March 2007.

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.