Journal List > J Korean Ophthalmol Soc > v.52(6) > 1009058

Jang, Park, and Kim: Usefulness of Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Index as Predictors of Early Age-Related Maculopathy

Abstract

Purpose

Age-related maculopathy (ARM) is a major cause of blindness. For this reason, an early predictor of ARM is necessary for early detection and preventive therapy. The present study investigated arterial stiffness and stenosis using ankle brachial index (ABI) and pulse wave velocity (PWV) and analyzed whether arterial stiffness was affected by the extent of ARM.

Methods

A total of 257 randomized patients were enrolled in the present study. All participants underwent baPWV, ABI, blood pressure, total cholesterol, and triglyceride evaluation and were questioned regarding their history of smoking. The extent of ARM was expressed using Wisconsin ARM grading.

Results

Of the 257 patients, 29 were diagnosed with early ARM using Wisconsin ARM grading. The average age of the ARM group was 53 ± 6.56 years and was significantly greater than the average 45.93 ± 8.61 years in the non-ARM group. Other than ankle-brachial index, the clinical variables showed no significant differences after a refining process for age-related variables. Ankle-brachial index was significantly lower in the ARM group than it was in the non-ARM group (1.08 ± 0.052, 1.12 ± 0.051, respectively).

Conclusions

The ARM group showed significantly increased arterial stenosis. The present study provides a basis for the use of PWV in the early detection of ARM; however, longitudinal studies employing a larger population are required to determine the diagnostic and prognostic implications of PWV in ARM.

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Figure 1.
Pulse wave analyzer and report of the result. Brachial-ankle pulse wave velocity was measured with a volume-plethysmo-graphic apparatus (automatic waveform analyzer: VP-1000, Colin Co, Komaki, Japan). This instrument simultaneously records the brachial-ankle pulse wave velocity, brachial-ankle pressure index, electrocardiogram and heart sound.
jkos-52-696f1.tif
Figure 2.
Ankle-brachial index (ABI) measurement. ABI < 0.5: severe peripheral arterial occlusive disease (PAOD); 0.5 < ABI <0.9: mild to moderate PAOD; 0.9 < ABI < 1.3: normal; ABIb > 1.3: non compressible (medial sclerosis, calcification).
jkos-52-696f2.tif
Table 1.
Baseline clinical characteristics of the study cohort
Factors Early ARM (n = 29) Non-ARM (n = 228) p-value
Age (mean ± SD, yr) 53.00 ± 6.56 45.99 ± 8.58 <0.001
Sex (M:F) 20:9 141:87 0.457
Diabetes mellitus (Y:N) 25:4 210:18 0.314
Hypertension (mm Hg) 24:5 197:31 0.153
Systolic blood pressure (mean ± SD, mm Hg) 124.00 ± 13.53 120.80 ± 13.11 0.197
Diastolic blood pressure (mean ± SD, mm Hg) 82.76 ± 9.57 78.88 ± 10.42 0.725
Pulse wave velocity (%)      
 Within normal range 14 (48.2) 133 (58.3) 0.564
 Slightly harder 10 (34.4) 60 (26.3)  
 Harder 5 (17.2) 35 (15.3)  
 Probably occlusion 0 (0.0) 0 (0.0)  
Ankle brachial index (mean ± SD) 1.10 ± 0.071 1.10 ± 0.072 0.846
Total cholesterol (mean ± SD, mg/dl) 191.24 ± 45.24 198.15 ± 31.86 0.298
LDL cholesterol (mean ± SD, mg/dl) 117.41 ± 22.27 115.67 ± 28.41 0.780
HDL cholesterol (mean ± SD, mg/dl) 52.10 ± 8.39 52.47 ± 28.52 0.950
Triglyceride (mean ± SD, mg/dl) 102.55 ± 44.83 131.67 ± 79.07 0.052
Smoking (%)      
 Non-smoker 20 (68.9) 145 (63.5) 0.450
 1-11 pack-yr 1 (3.4) 25 (10.9)  
 >11 pack-yr 8 (23.5) 58 (25.4)  
Body mass index (mean ± SD, Kg/m2) 24.63 ± 2.65 24.07 ± 3.06 0.347

p-value by independent T-test.

ARM = age-related maculopathy.

Table 2.
Clinical characteristics of the study after controlling of age factor
Factors Early ARM (n = 23) Non-ARM (n = 102) p-value
Age (mean ± SD, yr) 52.91 ± 4.70 50.38 ± 6.57 0.084
Sex (M:F) 17:6 68:34 0.314
Diabetes mellitus (Y:N) 20:3 94:8 0.264
Hypertension (mm Hg) 19:4 191:11 0.165
Systolic blood pressure (mean ± SD, mm Hg) 122.14 ± 12.17 121.28 ± 12.08 0.213
Diastolic blood pressure (mean ± SD, mm Hg) 83.65 ± 9.31 79.48 ± 9.82 0.481
Pulse wave velocity (%)      
 Within normal range 12 (52.1) 53 (51.9) 0.487
 Slightly harder 8 (34.7) 28 (27.4)  
 Harder 3 (13.0) 21 (20.5)  
 Probably occlusion 0 (0.0) 0 (0.0)  
Ankle brachial index (mean ± SD) 1.08 ± 0.052 1.12 ± 0.051 0.042
Total cholesterol (mean ± SD, mg/dl) 193.30 ± 48.36 198.68 ± 33.22 0.523
LDL cholesterol (mean ± SD, mg/dl) 115.36 ± 21.42 113.82 ± 26.56 0.428
HDL cholesterol (mean ± SD, mg/dl) 51.87 ± 8.24 53.98 ± 26.24 0.891
Triglyceride (mean ± SD, mg/dl) 103.12 ± 43.27 128.54 ± 75.31 0.052
Smoking (%)      
 Non-smoker 15 (65.2) 76 (74.5) 0.658
 1-11 pack-yr 1 (4.3) 11 (10.7)  
 >11 pack-yr 8 (34.7) 15 (14.7)  
Body mass index (mean ± SD, Kg/m2) 24.25 ± 2.13 23.34 ± 2.51 0.326

p-value by independent T-test.

ARM = age-related maculopathy.

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