Biomedical subjects

Michael D Knudtson

Publications and source records attributed to Michael D Knudtson.

At least 19 recordsLinked to original sources

PubMed2006

Retinal vein occlusion and vascular mortality: pooled data analysis of 2 population-based cohorts.

PURPOSE: To assess the association of retinal vein occlusion (RVO) with cardiovascular and cerebrovascular mortality. DESIGN: Pooled data from 2 population-based cohort studies. PARTICIPANTS: At baseline, the Beaver Dam Eye Study (BDES) examined 4926 persons aged 43 to 86 years (from 1988-1990) and the Blue Mountains Eye Study (BMES) examined 3654 persons aged 49 to 97 years (from 1992 to 1994). METHODS: Retinal vein occlusion was assessed from retinal photographs. Vascular deaths were determined using either death certificates (BDES) or the Australian National Death Index (BMES). Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). MAIN OUTCOME MEASURE: Vascular (cardiovascular and cerebrovascular) mortality was determined. RESULTS: Of 8384 baseline participants, 96 (1.14%) had RVO at baseline (BDES, n = 38; BMES, n = 58). Over 12 years, 1312 (15.7%) died of cardiovascular-related conditions and 341 (4.1%) died of cerebrovascular-related conditions. Age-standardized vascular mortality rates were 26.0% and 5.3%, respectively, in persons with RVO and 17.1% and 4.5%, respectively, in those without RVO. After adjusting for age, gender, body mass index, hypertension, diabetes, smoking, glaucoma, and study site, RVO was not associated with cardiovascular-related mortality (HR, 1.2; 95% CI, 0.8-1.8) or cerebrovascular-related mortality (HR, 0.9; 95% CI, 0.4-2.1) among participants of all ages. However, in persons aged less than 70 years, baseline RVO was associated with higher cardiovascular mortality (combined BDES and BMES: HR, 2.5; 95% CI, 1.2-5.2; BDES: HR, 2.5; 95% CI, 0.9-6.9; BMES: HR, 2.1; 95% CI, 0.7-6.8). CONCLUSIONS: Retinal vein occlusion in persons aged 43 to 69 years may signal a doubling of the risk of cardiovascular mortality.

Adult↗

PubMed2006

Frailty and age-related cataract.

OBJECTIVE: To determine whether there is an association between age-related cataract and frailty that persists after controlling for visual acuity (VA) and comorbid conditions. DESIGN: Cross-sectional. PARTICIPANTS: Two thousand three hundred seventy Beaver Dam Eye Study cohort members at 10-year (third) examination with cataract information. Ninety-nine percent of the population was Caucasian. METHODS: Medical history, blood pressures, height, weight, measures of frailty, and lens photographs were obtained during the study evaluation. Lens photographs were graded according to standardized protocols. MAIN OUTCOME MEASURES: Four of frailty (gait time, peak expiratory flow rate, handgrip strength, chair stand) and an index combining all 4 measures. RESULTS: After controlling for age, age squared, comorbidity index, pack-years, sedentary lifestyle, education, and VA, nuclear cataract in women was not associated significantly with any frailty measures; in men, nuclear cataract was associated with slower gait time (P = 0.01) and a poorer frailty index score (P = 0.01) in multivariable analyses. Cortical cataract was associated in women with a lower peak expiratory flow rate (P<0.01) and in men with weaker handgrip strength (P = 0.02) and a poorer frailty index score (P</=0.01) in multivariable analyses. Posterior subcapsular cataract in women was associated significantly with a lower peak expiratory flow rate (P = 0.01). Nuclear and cortical cataract add significant information in explaining frailty index scores in men. CONCLUSIONS: Three common types of age-related cataract are associated with some measures of frailty independent of VA and systemic comorbidities. It is possible that age-related cataract may be an indicator of general functional decline in older adults.

Adult↗

PubMed2006

Retinal arteriolar emboli and long-term mortality: pooled data analysis from two older populations.

BACKGROUND AND PURPOSE: To assess the relationship between retinal arteriolar emboli and mortality in older people. METHODS: Pooled data from 2 population-based cohort studies. At baseline, the Beaver Dam Eye Study (BDES) examined 4926 persons 43 to 86 years of age (1988 to 1990), and the Blue Mountains Eye Study (BMES) examined 3654 persons 49 to 97 years of age (1992 to 1994). Retinal arteriolar emboli were assessed by grading retinal photographs using standardized methods. Deaths and causes of death were determined from death certificates or Australian National Death Index. Cox regression models were used to estimate mortality hazard ratios (HRs) associated with emboli, adjusting for age, gender, body mass index, hypertension, diabetes, smoking, serum total cholesterol, high-density lipoprotein cholesterol, study site, and past histories of stroke, angina, and acute myocardial infarct. RESULTS: Of 8580 baseline participants, 8384 (98%) had retinal photographs available, and 111 showed retinal arteriolar emboli (BDES n=61; BMES n=50). Over 10 to 12 years, 2506 participants (30%) died, including 344 (4%) from stroke-related and 1315 (16%) from cardiovascular causes. The cumulative mortality rates were higher in participants with than without emboli (all-cause 56% versus 30%; stroke-related 12% versus 4.0%; cardiovascular 30% versus 16%). The increased mortality risk associated with emboli was independent of age, gender, other vascular risk factors, and past histories of stroke or heart disease for all-cause (multivariate-adjusted HR, 1.3; CI, 1.0 to 1.8) and stroke-related mortality (HR, 2.0; CI, 1.1 to 3.8) but not for cardiovascular mortality (HR, 1.2; CI, 0.8 to 1.7). CONCLUSIONS: Our pooled data from 2 older populations suggest that retinal emboli predict a modest increase in all-cause and stroke-related mortality independent of cardiovascular risk factors.

Adult↗

PubMed2006

The relationship of optic disk cupping to retinal vein occlusion: the Beaver Dam Eye Study.

PURPOSE: To examine the association between optic disk cupping and retinal vein occlusion (RVO). DESIGN: Prospective epidemiologic study. METHODS: setting: Population-based prospective study in Beaver Dam, Wisconsin. study population: Adults aged 43 to 86 years at baseline (n = 4926). observation procedures: Optic disk cupping and RVO were determined from retinal photographs. A standardized medical examination and questionnaire were administered. main outcome measure: Ten-year cumulative incidence of RVO. RESULTS: There were 58 persons who developed incident RVO at 5 (n = 31) or 10 (n = 27) years after the baseline examination. Those sustaining RVO were older, had higher intraocular pressure (IOP), and were more likely to have definite or probable glaucoma at the baseline examination. The odds of having an incident RVO increased with increasing cup-to-disk ratio at baseline (odds ratio [OR] = 1.29/0.1 increase in cup-to-disk ratio, 95% confidence interval 1.07, 1.56), while controlling for age, systolic blood pressure, current smoking, diabetes status, and IOP. A similar OR was found after excluding those with glaucoma. Excluding persons with central (as opposed to branch) vein occlusion did not have a significant effect on the OR. CONCLUSION: Cup-to-disk ratio is a significant predictor of risk of incident RVO.

Adult↗

PubMed2006

Are inflammatory factors related to retinal vessel caliber? The Beaver Dam Eye Study.

OBJECTIVE: To examine the relationship of systemic markers of inflammation, endothelial dysfunction, and serum folate level to retinal vessel diameter. METHODS: Cross-sectional analyses were completed for data from a random sample of 396 persons aged 50 to 86 years who underwent a baseline examination from 1988 to 1990. Standardized protocols for blood collection and measurement of markers were used. Diameters of arterioles and venules were measured from digitized photographs. Standard univariate and multivariate analyses were performed. RESULTS: While controlling for age, smoking status, diabetes status, serum high-density lipoprotein cholesterol, and hematocrit, wider retinal venular diameters were associated with higher serum high-sensitivity C-reactive protein, interleukin 6, and amyloid A levels. While controlling for age, systolic and diastolic blood pressure, smoking, serum high-density lipoprotein cholesterol level, and gout, smaller arteriolar diameters were associated with higher serum amyloid A and lower serum albumin and folate levels but not high-sensitivity C-reactive protein or interleukin 6 levels. Levels of serum soluble intercellular adhesion molecule-1 and serum soluble E-selectin, markers of endothelial dysfunction, were not associated with retinal arteriolar or venular diameters. CONCLUSIONS: These data show an association of inflammatory markers with larger retinal venular diameter, suggesting that retinal venular caliber may be a marker of systemic inflammation.

Aged↗

PubMed2006

Age-related eye disease, visual impairment, and survival: the Beaver Dam Eye Study.

OBJECTIVE: To investigate the relationship of age-related maculopathy, cataract, glaucoma, visual impairment, and diabetic retinopathy to survival during a 14-year period. METHODS: Persons ranging in age from 43 to 84 years in the period from September 15, 1987, to May 4, 1988, participated in the baseline examination of the population-based Beaver Dam Eye Study (n = 4926). Standardized protocols, including photography, were used to determine the presence of ocular disease. Survival was followed using standardized protocols. RESULTS: As of December 31, 2002, 32% of the baseline population had died (median follow-up, 13.2 years). After adjusting for age, sex, and systemic and lifestyle factors, poorer survival was associated with cortical cataract (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.06-1.37), any cataract (HR, 1.16; 95% CI, 1.03-1.32), diabetic retinopathy (HR per 1-step increase in 4-level severity, 1.36; 95% CI, 1.14-1.63), and visual impairment (HR, 1.24; 95% CI, 1.04-1.48) and marginally associated with increasing severity of nuclear sclerosis (HR, 1.07; 95% CI, 0.99-1.16). Age-related maculopathy and glaucoma were not associated with poorer survival. Associations tended to be slightly stronger in men than women. CONCLUSIONS: Cataract, diabetic retinopathy, and visual impairment were associated with poorer survival and not explained by traditional risk factors for mortality. These ocular conditions may serve as markers for mortality in the general population.

Adult↗

PubMed2006

Markers of inflammation, vascular endothelial dysfunction, and age-related cataract.

PURPOSE: To examine the associations of systemic markers of inflammatory disease and vascular endothelial dysfunction with three types of age-related cataract. DESIGN: Cross-sectional analyses of data from a population-based sample of adults. METHODS: Standardized protocols for blood collection, measurement of markers, administration of a questionnaire, and grading of lens photographs to determine cataract were used. Univariable and multivariable analyses were performed. SETTINGS: Cohort in Beaver Dam, Wisconsin. STUDY POPULATION: A random sample of 396 persons who were > or =50 years of age. MAIN OUTCOME MEASURE: Prevalent age-related nuclear, cortical, and posterior subcapsular cataract. RESULTS: Interleukin-6 and intracellular adhesion molecule-1 were associated significantly with prevalent nuclear cataract (odds ratio for each quartile, 1.45 and 2.17, respectively). Many of the associations of markers with cataract types were not linear. There were no significant associations between the markers and cortical or posterior subcapsular cataract. CONCLUSION: Two serum markers of systemic inflammation and vascular endothelial dysfunction were associated with nuclear cataract.

Adult↗

PubMed2006

Age-related macular degeneration and optic disk cupping: the Beaver Dam Eye Study.

PURPOSE: To examine the association between presence, severity, and extent of lesions of age-related macular degeneration (AMD) and optic disk and cup diameters in a general population. DESIGN: Cross-sectional study. METHODS: setting: Population-based. study population: Adults aged 43 to 86 years participating in the Beaver Dam Eye Study. observation procedures: Fundus photographs were graded for lesions of AMD using standard protocols. The photographs were obtained during the baseline examination of the Beaver Dam Eye Study. main outcome measure: Optic disk cupping as related to presence, severity, and extent of lesions of AMD. RESULTS: There were no significant differences in the vertical optic disk and cup measurements or in the vertical cup to disk ratios by severity of lesions of AMD (P values all greater than .10). In those eyes with late lesions of AMD, there was no association of the size of the lesions or their distribution in the fundus and the extent of cupping. CONCLUSIONS: From a population perspective, there is no relationship of the presence or severity of AMD and optic disk cupping.

Adult↗

PubMed2006

Comparison of retinal vessel measurements in digital vs film images.

PURPOSE: To compare central retinal artery equivalents (CRAE) and central retinal vein equivalents (CRVE) from vessels measured from images captured with a digital camera and digitized images taken with a film camera. DESIGN: Comparison of techniques. METHODS SETTING: Clinic. PATIENTS: A total of 75 eyes of 48 adults. OBSERVATION PROCEDURES: Gradings of retinal vessel diameters from images produced by using two photographic techniques: directly from a 45 degrees digital camera and digitized by scanning from a 30 degrees film-based camera. MAIN OUTCOME MEASURE: Differences in CRAE and CRVE from two types of images. RESULTS: CRAE and CRVE were highly comparable between the two techniques with correlation coefficients of 0.88 and 0.87, respectively. CONCLUSION: Estimates of CRAE and CRVE from measurements taken from digitally captured and digitized film-based images were highly comparable. It is likely that inferences about factors associated with retinal vessel diameters will be unbiased by the method of imaging.

Adult↗

PubMed2006

Prevalence of age-related macular degeneration in 4 racial/ethnic groups in the multi-ethnic study of atherosclerosis.

OBJECTIVE: To describe the prevalence of age-related macular degeneration (AMD) in 4 racial/ethnic groups (white, black, Hispanic, and Chinese) that participated in the second examination of the Multi-ethnic Study of Atherosclerosis (MESA). DESIGN: Prospective cohort study. PARTICIPANTS: Six thousand one hundred seventy-six 45- to 85-year-old subjects selected from 6 United States communities. METHODS: Fundus images were taken using a 45 degrees digital camera through dark-adapted pupils and were graded for drusen size, type, area, increased retinal pigment, retinal pigment epithelial depigmentation, neovascular lesions, and geographic atrophy using the modified Wisconsin Age-Related Maculopathy Grading System. MAIN OUTCOME MEASURE: Age-related macular degeneration. RESULTS: Prevalences of AMD were 2.4% (black), 4.2% (Hispanic), 4.6% (Chinese), to 5.4% (white) (P<0.001 for any differences among groups). The highest prevalence of any AMD occurred in those 75 to 84 years old, varying from 7.4% in blacks to 15.8% in whites and Chinese (P = 0.03). Estimated prevalences of late AMD were 0.3% (black), 0.2% (Hispanic), 0.6% (white), and 1.0% (Chinese). These differences were marginally significant (age and gender adjusted, P = 0.08). The frequency of exudative AMD was highest in Chinese (age- and gender-adjusted odds ratio, 4.30; 95% confidence interval, 1.30-14.27) compared with whites. Differences in age, gender, pupil size, body mass index, smoking, alcohol drinking history, diabetes, and hypertension status did not explain the variability among the 4 racial/ethnic groups. CONCLUSIONS: Low prevalences of AMD were found in the MESA cohort in all groups. A lower prevalence of AMD was found in blacks compared with whites. The higher prevalence of exudative AMD in Chinese needs further study.

Age Distribution↗

PubMed2006

Lens opacities associated with performance-based and self-assessed visual functions.

OBJECTIVE: To investigate the relationship of lens opacities to performance-based and self-assessed visual function in persons free of other ocular comorbidities. DESIGN: Cross-sectional cohort study. PARTICIPANTS: Beaver Dam Eye Study participants. METHODS: Lens photographs were taken and graded by protocols for age-related lens opacities. During the study evaluation, best-corrected visual acuity, near vision, and contrast sensitivity (performance-based visual functions) were measured. Questions were asked about visual function in particular settings (self-assessed visual functions). RESULTS: After the exclusion of other ocular comorbidities, performance-based visual functions were associated significantly (P< or =0.001 for each association) with severity of lens opacities, including relatively early lens opacities. Self-assessed visual functions were associated less consistently with severity of lens opacities (P<0.02 for all). In age-stratified analyses, there were fewer significant associations of self-assessed visual functions with severity of lens opacities for persons younger than 65 years than for persons 65 or older. CONCLUSIONS: Lens opacities across the range of severities were associated with measurable decreases in visual functions; the associations, especially for self-assessed functions, tended to be greater at older ages. It is likely that successful measures to decrease the severity of lens opacities will have a greater impact on older persons.

Aged↗

PubMed2005

Frailty, morbidity and survival.

Frailty, as a reflection of decreased physical reserve rather than disability, is assessed by various functional tests rather than by specific disease burden. We investigated association of measures of frailty to disease outcomes and survival in a population-based study of Midwestern adults. The markers of frailty we evaluated were: time to walk a measured course (gait-time), handgrip strength, peak respiratory flow rate, ability to stand from a sitting position without using arms, and best corrected visual acuity. A history of cardiovascular disease, cancer, and hypertension were obtained. Data were collected at the third examination (1998--2000) of the Beaver Dam Eye Study cohort (n=2962). Follow-up for mortality occurred up to 412 years after the 1998--2000 examinations. Markers of frailty were significantly associated with age. Values in the highest quartile (slowest) of gait-time, lowest quartile of peak expiratory flow rate, lowest quartile of handgrip strength, inability to stand from sitting in one try (those not in a wheelchair), and visual impairment were combined in an index to denote a general description of frailty. The range of the index was 0 (no frailty) to 5 (maximum frailty). Greater frailty was significantly associated with cardiovascular disease and hypertension. Frailty was associated with poorer survival over an interval of 412 years after adjusting for age, sex, hypertension, diabetes, and cardiovascular disease. Greater frailty was associated with greater likelihood of concurrent medical conditions and with decreased survival.

Aged↗

PubMed2005

Age-related eye disease, quality of life, and functional activity.

OBJECTIVE: To examine the associations of measures of quality of life (Medical Outcomes Study Short Form Health Survey) and functional activities (activities of daily living, instrumental activities of daily living, and visual function) in persons with and without age-related eye diseases. METHODS: Two thousand, six hundred seventy persons participated in the 1998 through 2000 examinations of both the Beaver Dam Eye Study and the Epidemiology of Hearing Loss Study. Age-related eye disease (age-related maculopathy, cataract, diabetic retinopathy, glaucoma, macula edema, occlusions, amblyopia, and macular holes) were assessed by fundus, slitlamp, and retroilluminated photographs and self-reported ocular history. Also administered was a standard interview that included the Medical Outcomes Study Short Form Health Survey, activities of daily living, instrumental activities of daily living, and visual function questionnaires and information on other medical conditions. RESULTS: After controlling for age and sex, we found that persons with an age-related eye disease had decreased scores in almost all the domains of the Medical Outcomes Study Short Form Health Survey, and persons with eye disease in both eyes had poorer scores than persons with eye disease in only 1 eye. Stratifying by age-related maculopathy and central cataract yielded similar results. Further adjustment for current visual acuity and the number of comorbid conditions explained most associations. Several of the mental scales were still marginally significantly lower (P<.10) in persons with age-related maculopathy after adjustment. Persons with an age-related eye disease were not more likely to have impaired activities of daily living or instrumental activities of daily living. After adjustment for current visual acuity and number of comorbidities, persons who had trouble reading small print or recognizing people across the street were more likely to have an age-related eye disease. Otherwise, there were no significant associations with the visual function questions and any of the specific ocular conditions. CONCLUSIONS: Many measures of general quality of life and functional activities were related to age-related eye diseases, but few associations remained significant after adjustments for vision and other comorbidities. Our data are compatible with the notion that decreased visual function, irrespective of the pathologic reason for the decrease, is associated with diminished quality of life and functional activities of living.

Activities of Daily Living↗

PubMed2005

Medication use and retinal vessel diameters.

PURPOSE: To study the influence of different medications on retinal vessel diameters. DESIGN: Cross-sectional study. METHODS: Retinal photographs in the Beaver Dam Eye Study (n = 4926, aged 43 to 84 years) were digitized, and the diameters of retinal vessels were measured. Participants' current medications were recorded at the examination. RESULTS: There were few significant associations between medication use and retinal vessel diameters. After adjusting for age, blood pressure, and other factors, participants who were using topical beta-blocker eyedrops had narrower retinal arteriolar (P = .05) and venular (P = .006) diameters than nonusers. Systemic beta-blocker was not associated with retinal vessel diameter size. CONCLUSION: We found few associations between current medication use and retinal vessel diameter. Retinal vessels were narrowed in those taking antiglaucoma medications, most strikingly in those prescribed topical beta-blockers, although such a relationship could not be established among those using systemic beta-blockers.

Adult↗

PubMed2005

Frailty and age-related macular degeneration: the Beaver Dam Eye Study.

PURPOSE: To investigate the associations of measures of frailty to prevalent age-related maculopathy (ARM). DESIGN: Cross-sectional population-based study. METHODS: Time to walk a measured course (gait-time), handgrip strength, peak expiratory flow rate, ability to stand from a sitting position without using arms, self-reported co-morbidities, and ARM were assessed at the third examination of the Beaver Dam Eye Study (n = 2,962). ARM was determined by grading stereoscopic color fundus photographs. RESULTS: While controlling for age, smoking, and the number of co-morbid conditions, weaker handgrip strength was associated with early ARM (odds ratio [OR]/10 kg decrease 1.28, confidence interval [CI] 1.08, 1.52, P = .004) and late ARM (OR 1.55, 95% CI 1.02, 2.36) in men but not women. Other measures of frailty were not related to ARM. CONCLUSIONS: A weak cross-sectional association of handgrip strength with ARM (in men) was found after controlling for co-morbid conditions. These data suggest that ARM is due to a specific disease process, albeit age-related, rather than to biologic aging, as reflected by measures of frailty.

Adult↗

PubMed2005

Systemic markers of inflammation, endothelial dysfunction, and age-related maculopathy.

PURPOSE: To examine the association of systemic markers of inflammatory disease and endothelial dysfunction with age-related maculopathy (ARM). DESIGN: (1) Nested case-control analysis of prevalent ARM and (2) prospective analyses of incident ARM in a random sample of a population-based cohort. METHODS: Standardized protocols for blood collection, measurement of markers, administration of a questionnaire, and gradings of stereoscopic color fundus photography to determine ARM were used. Standard univariate and multivariate analyses were performed. participants: Included in the nested case-control study were 188 cases with moderate to advanced ARM and 195 controls matched for age, gender, and current smoking status at a baseline examination from 1988 to 1990, and living in Beaver Dam, Wisconsin. Included in the prospective analyses as a random sample of 321 persons were those who participated in a 5-year and/or 10-year follow-up. main outcome measures: Prevalent and incident ARM. RESULTS: Serum C-reactive protein, amyloid A, interleukin-6, tumor necrosis factor-alpha, intracellular adhesion molecule, E-selectin, folate, and Chlamydia pneumoniae IgG antibody were not associated with either prevalent or incident ARM. CONCLUSION: Contrary to other reports, we cannot confirm a strong or consistent relationship of markers of inflammation and endothelial dysfunction with ARM.

Adult↗

PubMed2005

Associations with weight loss and subsequent mortality risk.

PURPOSE: Studies have shown a high prevalence of weight loss in older adults is associated with an increased risk of death. We investigated this in a population-based study. METHODS: Persons living in Beaver Dam, Wisconsin, participated in a baseline examination between 1988 and 1990 (n=4926). A medical examination and standardized questionnaire were administered. Weight loss was defined as percent loss in body weight from highest lifetime weight to measured weight at baseline. RESULTS: Weight loss was associated with older age, higher rates of diseases such as diabetes, and lower baseline levels of blood pressure and serum total cholesterol. After controlling for age, medical, and lifestyle factors, both men and women had higher mortality rates over a 10+ year period for increasing categories of weight loss (hazard ratio [ 95% CI]: 1.16 [1.06, 1.27] for men and 1.23 [1.13, 1.34] for women). Increased mortality rates with increasing weight loss was shown in stratified analyses of age, body mass index (BMI) at highest weight, smoking, and disease status, but did not always reach statistical significance. Persons on weight loss diets within the year prior to baseline did not have increased mortality with increasing weight loss. CONCLUSION: The strong association between weight loss (likely involuntary) and mortality may be a useful way of estimating overall risks to longevity in populations.

Adult↗

PubMed2005

Estrogen replacement therapy and retinal vascular caliber.

OBJECTIVE: It is unclear if estrogen replacement therapy (ERT) has an effect on the retinal circulation. In the current study, we examine the association of ERT, female reproductive factors, and retinal vascular caliber. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Women participants aged 43 to 84 years living in Beaver Dam, Wisconsin. METHODS: Retinal photographs of participants taken at the baseline examination were digitized, and the diameters of arterioles and venules were measured using a well-established technique. Estrogen replacement therapy and female reproductive factors were ascertained by interview. MAIN OUTCOME MEASURES: Retinal arteriolar and venular diameters. RESULTS: Of the 2469 women participants with data for analysis, 10.5% were current users of ERT and 7.4% were past users. After adjusting for age, blood pressure (BP), body mass index, smoking, and other factors, women who were current users of ERT had narrower retinal arteriolar and venular diameters than those who were past users or never used, with mean arteriolar diameters of 167.6 microm for current users, 170.8 microm for past users, and 170.9 microm for those who never used (P = 0.009) and mean venular diameters of 239.9 microm for current users, 244.0 microm for past users, and 243.9 microm for those who never used (P = 0.02). There was a significant trend of increasing narrowing for both arterioles (P trend, 0.01) and venules (P trend, 0.007) with increasing duration of ERT. Associations were somewhat stronger in younger women and women without a history of hypertension and cigarette smoking. Female reproductive factors (e.g., age of menarche and pregnancy) were not associated with retinal vessel diameters. CONCLUSIONS: Estrogen replacement therapy is associated with narrower retinal vessel diameters, independent of BP and other vascular factors.

Adult↗