@article {1129, title = {Meta-analysis: retinal vessel caliber and risk for coronary heart disease.}, journal = {Ann Intern Med}, volume = {151}, year = {2009}, month = {2009 Sep 15}, pages = {404-13}, abstract = {

BACKGROUND: Retinal vessel caliber may be a novel marker of coronary heart disease (CHD) risk. However, the sex-specific effect, magnitude of association, and effect independent of traditional CHD disease risk factors remain unclear.

PURPOSE: To determine the association between retinal vessel caliber and risk for CHD.

DATA SOURCES: Relevant studies in any language identified through MEDLINE (1950 to June 2009) and EMBASE (1950 to June 2009) databases.

STUDY SELECTION: Studies were included if they examined a general population, measured retinal vessel caliber from retinal photographs, and documented CHD risk factors and incident CHD events.

DATA EXTRACTION: 6 population-based prospective cohort studies provided data for individual participant meta-analysis.

DATA SYNTHESIS: Proportional hazards models, adjusted for traditional CHD risk factors, were constructed for retinal vessel caliber and incident CHD in women and men. Among 22,159 participants who were free of CHD and followed for 5 to 14 years, 2219 (10.0\%) incident CHD events occurred. Retinal vessel caliber changes (wider venules and narrower arterioles) were each associated with an increased risk for CHD in women (pooled multivariable-adjusted hazard ratios, 1.16 [95\% CI, 1.06 to 1.26] per 20-microm increase in venular caliber and 1.17 [CI, 1.07 to 1.28] per 20-microm decrease in arteriolar caliber) but not in men (1.02 [CI, 0.94 to 1.10] per 20-microm increase in venular caliber and 1.02 [CI, 0.95 to 1.10] per 20-microm decrease in arteriolar caliber). Women without hypertension or diabetes had higher hazard ratios.

LIMITATION: Error in the measurement of retinal vessel caliber and Framingham variables was not taken into account.

CONCLUSION: Retinal vessel caliber changes were independently associated with an increased risk for CHD events in women.

}, keywords = {Adult, Aged, Arterioles, Biomarkers, Coronary Disease, Female, Humans, Male, Middle Aged, Proportional Hazards Models, Retinal Vessels, Risk Factors, Sex Factors, Venules}, issn = {1539-3704}, author = {McGeechan, Kevin and Liew, Gerald and Macaskill, Petra and Irwig, Les and Klein, Ronald and Klein, Barbara E K and Wang, Jie Jin and Mitchell, Paul and Vingerling, Johannes R and Dejong, Paulus T V M and Witteman, Jacqueline C M and Breteler, Monique M B and Shaw, Jonathan and Zimmet, Paul and Wong, Tien Y} } @article {1142, title = {Prediction of incident stroke events based on retinal vessel caliber: a systematic review and individual-participant meta-analysis.}, journal = {Am J Epidemiol}, volume = {170}, year = {2009}, month = {2009 Dec 01}, pages = {1323-32}, abstract = {

The caliber of the retinal vessels has been shown to be associated with stroke events. However, the consistency and magnitude of association, and the changes in predicted risk independent of traditional risk factors, are unclear. To determine the association between retinal vessel caliber and the risk of stroke events, the investigators combined individual data from 20,798 people, who were free of stroke at baseline, in 6 cohort studies identified from a search of the Medline (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier B.V., Amsterdam, the Netherlands) databases. During follow-up of 5-12 years, 945 (4.5\%) incident stroke events were recorded. Wider retinal venular caliber predicted stroke (pooled hazard ratio = 1.15, 95\% confidence interval: 1.05, 1.25 per 20-micron increase in caliber), but the caliber of retinal arterioles was not associated with stroke (pooled hazard ratio = 1.00, 95\% confidence interval: 0.92, 1.08). There was weak evidence of heterogeneity in the hazard ratio for retinal venular caliber, which may be attributable to differences in follow-up strategies across studies. Inclusion of retinal venular caliber in prediction models containing traditional stroke risk factors reassigned 10.1\% of people at intermediate risk into different, mostly lower, risk categories.

}, keywords = {Aged, Fluorescein Angiography, Humans, Middle Aged, Predictive Value of Tests, Proportional Hazards Models, Retinal Artery, Retinal Vein, Retinal Vessels, Risk Factors, Stroke}, issn = {1476-6256}, doi = {10.1093/aje/kwp306}, author = {McGeechan, Kevin and Liew, Gerald and Macaskill, Petra and Irwig, Les and Klein, Ronald and Klein, Barbara E K and Wang, Jie Jin and Mitchell, Paul and Vingerling, Johannes R and de Jong, Paulus T V M and Witteman, Jacqueline C M and Breteler, Monique M B and Shaw, Jonathan and Zimmet, Paul and Wong, Tien Y} }