RT Journal Article
SR Electronic
T1 Progression of retinopathy and incidence of cardiovascular disease: findings from the Chronic Renal Insufficiency Cohort Study
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 246
OP 252
DO 10.1136/bjophthalmol-2019-315333
VO 105
IS 2
A1 Juan E Grunwald
A1 Maxwell Pistilli
A1 Gui-Shuang Ying
A1 Maureen G Maguire
A1 Ebenezer Daniel
A1 Revell Whittock-Martin
A1 Candace Parker-Ostroff
A1 Douglas Jacoby
A1 Alan S Go
A1 Raymond R Townsend
A1 Crystal Ann Gadegbeku
A1 James P Lash
A1 Jeffrey Craig Fink
A1 Mahboob Rahman
A1 Harold Feldman
A1 John W Kusek
A1 Dawei Xie
A1 ,
YR 2021
UL http://bjo.bmj.com/content/105/2/246.abstract
AB Purpose Chronic kidney disease (CKD) patients often develop cardiovascular disease (CVD) and retinopathy. The purpose of this study was to assess the association between progression of retinopathy and concurrent incidence of CVD events in participants with CKD.Design We assessed 1051 out of 1936 participants in the Chronic Renal Insufficiency Cohort Study that were invited to have fundus photographs obtained at two timepoints separated by 3.5 years, on average.Methods Using standard protocols, presence and severity of retinopathy (diabetic, hypertensive or other) and vessel diameter calibre were assessed at a retinal image reading centre by trained graders masked to study participants’ information. Participants with a self-reported history of CVD were excluded. Incident CVD events were physician adjudicated using medical records and standardised criteria. Kidney function and proteinuria measurements along with CVD risk factors were obtained at study visits.Results Worsening of retinopathy by two or more steps in the EDTRS retinopathy grading scale was observed in 9.8% of participants, and was associated with increased risk of incidence of any CVD in analysis adjusting for other CVD and CKD risk factors (OR 2.56, 95% CI 1.25 to 5.22, p<0.01). After imputation of missing data, these values were OR=1.66 (0.87 to 3.16), p=0.12.Conclusion Progression of retinopathy is associated with higher incidence of CVD events, and retinal-vascular pathology may be indicative of macrovascular disease even after adjustment for kidney diseases and CVD risk factors. Assessment of retinal morphology may provide important information when assessing CVD in patients with CKD.