Early Retinal Vascular Abnormalities in African-American Cocaine Users

Leung, Ivan Y.-F.; Lai, Shenghan; Ren, Shiquan; Kempen, John; Klein, Ronald; Tso, Mark O.M.; Lai, Hong C.

doi:10.1016/j.ajo.2008.05.037

« Previous Next »American Journal of Ophthalmology
Volume 146, Issue 4 , Pages 612-619.e2, October 2008

Early Retinal Vascular Abnormalities in African-American Cocaine Users

Ivan Y.-F. Leung
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
Shenghan Lai
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland
Shiquan Ren
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland
John Kempen
- Departments of Ophthalmology and Biostatistics and Epidemiology, and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
Mark O.M. Tso
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
- The Peking University Eye Center, The Third Teaching Hospital of the Peking University, Beijing, China
Hong C. Lai
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland
- Inquiries to Hong C. Lai, Department of Radiology, 601 North Carolina Street, JHOC 3140G, Johns Hopkins School of Medicine, Baltimore, MD 21287

Accepted 28 May 2008. published online 28 July 2008.

Purpose

To investigate whether cocaine use is associated with early retinal vascular abnormalities.

Design

Population-based cross-sectional study.

Methods

settings: Inner-city neighborhoods in Baltimore, Maryland. study population: Sixty-eight participants were recruited from an ongoing observational study, investigating cardiovascular complications of human immunodeficiency virus (HIV) infection and cocaine use in African Americans aged between 25 and 54 years. Those with hypertension and known cardiovascular/cerebrovascular diseases were excluded. observation procedures: Ophthalmoscopic examinations and fundus photography of the retinas of these subjects were performed after pupillary dilation. The largest angle of arterial bifurcation (LAAB), central retinal artery equivalent (CRAE), and central retinal vein equivalent (CRVE) were measured by single-masked fundus image examiners. main outcome measures: LAAB, CRAE, and CRVE.

Results

Among the 68 study subjects, 52 (76.5%) were chronic cocaine users and 16 (23.5%) were non–cocaine users. Univariate and multivariate analyses indicated that the LAAB was associated with age and duration of cocaine use of more than 10 years. The LAAB was also inversely associated with very low-density lipoproteins levels. Multivariate analysis indicated a positive association between CRVE and cocaine use. CRAE was also associated with intravenous injection. We confirmed that CRAE was inversely associated with age. HIV infection was not found to be associated with any retinal vascular parameters.

Conclusions

Cocaine use is associated with increased retinal arterial branching angle and venular caliber. The retinal vascular changes provided the first evidence that cocaine use has an effect on the retinal vascular system.