Ophthalmology
Volume 112, Issue 4
,
April 2005,
Pages 548-552
doi:10.1016/j.ophtha.2004.10.038 
Copyright © 2005 American Academy of Ophthalmology Published by Elsevier Inc.
Original article
Retinal Vessel
Diameters and the Risk of Incident Age-Related Macular Disease
The Rotterdam study
M. Kamran Ikram MD, MSc1, Redmer van Leeuwen MD, PhD1, 2, Johannes R. Vingerling MD, PhD1, 2, Albert Hofman MD, PhD1 and Paulus T.V.M. de Jong MD, PhD1, 3, 4, 
, 
1Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
2Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
3The Netherlands Ophthalmic Research Institute, Koninklijke Nederlandse Akademie van Wetenschappen, Amsterdam, The Netherlands
4Department of Ophthalmology, Academic Medical Center, Amsterdam, The Netherlands
Received 31 August 2004; accepted 11 October 2004. Available online 11 February 2005.
Purpose
To study the relationship between 
retinal vessel diameters and incident age-related macular disease (iAMD).
Design
Prospective population-based cohort study.
Participants
Persons (55 years and older) from the Rotterdam Study, who participated at the baseline (1990–1993) and 1 of 2 follow-up examinations (1993–1994 and 1997–1999).
Methods
In the current analysis, 4345 participants who were free of AMD at baseline and had gradable macular transparencies at both baseline and follow-up examination were included. Also, arteriolar and venular diameters were measured on digitized baseline images. Stereoscopic transparencies of the macular region were graded according to the International Classification and Grading System for AMD. Incidence of AMD was defined as the development of soft distinct drusen with pigmentary changes or indistinct or reticular drusen with or without pigmentary changes (early iAMD) or atrophic or neovascular AMD (late iAMD). Logistic regression models were used to assess these associations, adjusting for age, gender, and follow-up time and, additionally, for smoking, body mass index, intima–media thickness, systolic blood pressure, and total and high-density lipoprotein cholesterol levels.
Main Outcome Measure
Incidence of AMD.
Results
After a mean follow-up time of 5.2 years, a total of 374 persons developed early and late iAMD. Neither arteriolar nor venular diameters were related to the risk of iAMD. The odds ratio (OR) per standard deviation (SD) decrease in arteriolar diameter was 1.03 (95% confidence interval [CI], 0.93–1.15), and the OR per SD increase in venular diameter was 1.04 (95% CI, 0.93–1.16). After categorizing the retinal vessel diameters into quintiles, there was no trend. After stratifying on age, only persons 75 years and older with smaller arteriolar diameters were at a borderline significant increased risk of iAMD: OR/SD decrease in arteriolar diameters adjusted for age, gender, follow-up time, and other cardiovascular risk factors, 1.24 (95% CI, 0.94–1.63).
Conclusion
Overall retinal vessel diameters were not related to the risk of iAMD in this general elderly population.
Manuscript no. 2004-68.
This study was supported by The Netherlands Organization for Scientific Research, The Hague, The Netherlands; Optimix Foundation, Amsterdam, The Netherlands; The Netherlands Society for the Prevention of Blindness, Doorn, The Netherlands; Blindenpenning Foundation, Amsterdam, The Netherlands; Fondsenwerving Volksgezondheid Foundation, The Hague, The Netherlands; Topcon Europe BV, Capelle aan den Ijssel, The Netherlands; and ROOS Foundation, Rotterdam, The Netherlands.
Correspondence to P. T. V. M. de Jong, The Netherlands Ophthalmic Research Institute, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
