Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study

Purpose To describe the relationship of retinal vascular calibre with diabetes and diabetic retinopathy in an Asian population. Methods A total of 3280 (78.7% response) subjects, aged 40-80 years, of Malay ethnicity residing in Singapore participated in this population-based, cross-sectional study. Retinal vascular calibre was measured and summarized using a validated computer programme from digital retinal photographs. Diabetic retinopathy signs were graded from photographs using the modified Airlie House classification. Results Of the 3004 subjects with data for this analysis, 682 (22.7%) had diabetes, of whom 194 (28.4%) had retinopathy. After multivariable adjustment, retinal arteriolar calibre was significantly wider in persons with diabetes (141 vs 139 mu m, P<0.001); venular calibre was not associated with diabetes (P = 0.93). Among participants with diabetes, venular calibre increased from 218.7 mu m in those without retinopathy to 231.1 mu m in those with moderate and 231.4 mu m in those with severe retinopathy (P for trend = <0.001); arteriolar calibre was not associated with diabetic retinopathy. Conclusions This study shows wider retinal arterioles in diabetes and wider venules in those with diabetic retinopathy in an Asian population. These findings confirm earlier data on white population, supporting the concept that a quantitative assessment of retinal vasculature may provide further insights into early diabetic microvascular damage. Eye (2009) 23, 1719-1724; doi: 10.1038/eye.2008.362; published online 12 December 2008