Statische Gefäßanalyse der retinalen Blutgefäße in einer populationsbasierten Kohorte unter Berücksichtigung des Diabetes mellitus

Zusammenfassung

Hintergrund Interdisziplinäre Untersuchungen möglicher Zusammenhänge zwischen Allgemeinerkrankungen und ophthalmologischen Veränderungen sind im klinischen Umfeld eher schwierig durchführbar; sie gewinnen jedoch durch den altersbedingten Anstieg chronischer Erkrankungen zunehmend an Bedeutung.

Methoden Die populationsbasierte SHIP-Trend-Studie wurde zwischen 2008 und 2012 in Greifswald durchgeführt. Die Baseline-Untersuchungen umfasste 4420 Probanden (Response 50,1%) im Alter von 20 bis 84 Jahren. Selbstangaben zu arterieller Hypertonie, Diabetes mellitus und Raucherstatus wurden erfragt, der Blutdruck und laborchemisch das HbA_1c wurden bestimmt. Die Gefäßdurchmesser retinaler Arteriolen und Venolen wurden mittels nonmydriatischer Augenhintergrundaufnahmen ermittelt und daraus das mittlere retinale arterielle (CRAE) und venöse Äquivalent (CRVE) berechnet. Die Assoziation von Diabetes mellitus, HbA_1c, Raucherstatus und Blutdruck mit den retinalen Gefäßparametern wurde adjustiert für Alter und Geschlecht mit linearen Regressionsmodellen geprüft.

Ergebnisse Bei 3218 Probanden mit auswertbaren standardisierten Fundusfotos zeigten sich signifikante Assoziationen von erhöhtem HbA_1c (> 6,5%), Raucherstatus, systolischem und diastolischem Blutdruck mit den retinalen Gefäßweiten CRAE und CRVE. Anamnestischer Diabetes mellitus war hingegen mit keinem der Gefäßparameter assoziiert.

Schlussfolgerung Diese Bevölkerungsstudie offenbart relevante Zusammenhänge zwischen Allgemeinerkrankungen und der retinalen Mikrostrombahn am Sehorgan. Daraus folgt, dass Allgemeinerkrankungen ophthalmologische Veränderungen begünstigen können. Die bildgebende Augenhintergrunduntersuchung kann aber auch umgekehrt Informationen zur Beurteilung allgemeiner Erkrankungen liefern.

Abstract

Background Interdisciplinary investigations of possible connections between general diseases and ophthalmological changes are difficult to perform in the clinical environment. But they are gaining in importance as a result of the age-related increase in chronic diseases. The collection of health-related parameters in the Study of Health in Pomerania (SHIP) project allows to derive conclusions for the general population.

Methods The population-based SHIP trend study was conducted between 2008 and 2012 in Greifswald. The baseline cohort included 4420 subjects (response 50.1%) at the age of 20 to 84 years. The pre-existence of arterial hypertension, diabetes mellitus and smoking status were questioned in a standardized questionnaire, the blood pressure and the HbA_1c were determined by the laboratory. The vascular diameter of retinal arterioles and venules were determined by means of non-mydriatic fundus images and the retinal arterial (CRAE) and venous equivalent (CRVE) were calculated therefrom. The association of diabetes mellitus, HbA_1c, smoking status and blood pressure with the retinal vascular parameters was tested for age and sex with linear regression models.

Results In 3218 subjects with evaluable standardized fundus photographs, significant associations of elevated HbA_1c (> 6.5%), smoking status and systolic and diastolic blood pressure were found with the retinal vessel widths CRAE and CRVE. Anamnestic diabetes mellitus, on the other hand, was not associated with any of the vascular parameters.

Conclusion This research study reveals a relevant correlation between general diseases and the retinal blood flow in the eye. Therefore, general diseases can induce ophthalmological changes and eye examination can provide information for the assessment of general diseases.

Schlüsselwörter

Retina - populationsbasierte Studie - Blutdruck - Hypertonie - glykiertes Hämoglobin - Augenerkrankungen

Key words

retina - population-based study - blood pressure - hypertension - glycated hemoglobin - ocular disease

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