Original articleRetinal Vascular Fractals and Microvascular and Macrovascular Complications in Type 1 Diabetes
Section snippets
Study Population
This study was a part of a cohort study of type 1 diabetes patients from Fyn County, Denmark. As previously described, the study participants were identified based on insulin prescriptions.15 All type 1 diabetes patients from Fyn County, Denmark, with an onset before the age of 30 years (n = 727) were identified as of 1 July 1973. In 1973, Fyn County had approximately 450 000 inhabitants and was considered a representative 9% sample of Denmark.15
In 2007, 208 (65.0%) of 320 surviving patients
Results
Of the 208 participants in the study, grading of retinal fractals was not possible in either eye of 30 patients (14.4%) because of severe media opacification (n = 10), fibrosis (n = 6), poor dilation (n = 5), missing pictures (n = 4), part of major vessel(s) missing (n = 3), or asteroid hyalosis (n = 2). Differences between patients with and without gradable retinal photos are shown in Table 1. In general, patients with ungradable fractals were older, had a longer duration of diabetes, were
Discussion
This study demonstrated an association between retinal fractal dimensions, a global measure of the retinal vascular pattern, and diabetes-related microvascular complications in long-term surviving Danish type 1 diabetes patients. Patients with eyes with smaller retinal fractals were more likely to have proliferative retinopathy, neuropathy, and nephropathy, while controlling for other risk factors including diabetes duration and glycemia levels. Retinal fractals were not related to
References (25)
- et al.
Retinal vascular caliber and risk of retinopathy in young patients with type 1 diabetes
Ophthalmology
(2006) - et al.
Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy
Ophthalmology
(2007) - et al.
Retinal vascular abnormalities in persons with type 1 diabetesThe Wisconsin Epidemiologic Study of Diabetic Retinopathy: XVIII
Ophthalmology
(2003) - et al.
Retinal microvascular abnormalities and incident stroke: the Atherosclerosis Risk in Communities Study
Lancet
(2001) - et al.
Retinal image analysis: concepts, applications and potential
Prog Retin Eye Res
(2006) - et al.
Retinal vascular caliber in persons with type 2 diabetesThe Wisconsin Epidemiological Study of Diabetic Retinopathy: XX
Ophthalmology
(2006) - et al.
Effect of panretinal photocoagulation on retinal blood flow in proliferative diabetic retinopathy
Ophthalmology
(1986) - et al.
Cardiovascular disease, mortality, and retinal microvascular characteristics in type 1 diabetes: Wisconsin Epidemiologic Study of Diabetic Retinopathy
Arch Intern Med
(2004) - et al.
Retinal arteriolar dilation predicts retinopathy in adolescents with type 1 diabetes
Diabetes Care
(2008) - et al.
The relation of retinal vessel caliber to the incidence and progression of diabetic retinopathy: XIX. The Wisconsin Epidemiologic Study of Diabetic Retinopathy
Arch Ophthalmol
(2004)
Retinal arteriolar caliber predicts incident retinopathy: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study
Diabetes Care
Retinal vessel diameters and the incidence of gross proteinuria and renal insufficiency in people with type 1 diabetes
Diabetes
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Manuscript no. 2009-1020.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Supported by the Velux Foundation, Copenhagen, Denmark; The Danish Eye Health Society, Copenhagen, Denmark; Sehested Hansen's Foundation, Copenhagen, Denmark; the Danish Diabetes Association, Odense, Denmark; the Synoptik Foundation, Copenhagen, Denmark; The A.P. Møller Foundation for the Advancement of Medical Science, Copenhagen, Denmark; The Danish Society of Ophthalmology, Copenhagen, Denmark; the Institute of Clinical Research at University of Southern Denmark, Copenhagen, Denmark; the Singapore National Medical Research Council, Singapore, Republic of Singapore (grant no.: STaR/0003/2008); and the Biomedical Research Council, (SBIC grant no.: C-011/2006) Singapore, Republic of Singapore. The funding organizations had no role in the design or conduct of this research.