Analysis of Factors Associated with Retinal Vascular Caliber in Normal Korean Subjects

Jong Chan Im; Jae Pil Shin; In Taek Kim; Dong Ho Park

doi:10.3341/jkos.2014.55.4.548

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Im, Shin, Kim, and Park: Analysis of Factors Associated with Retinal Vascular Caliber in Normal Korean Subjects

Original Article

J Korean Ophthalmol Soc 2014;55(4):548-554.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.4.548

Analysis of Factors Associated with Retinal Vascular Caliber in Normal Korean Subjects

Jong Chan Im, MD, Jae Pil Shin, MD, PhD, In Taek Kim, MD, PhD, Dong Ho Park, MD, PhD

Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea

Address reprint requests to Dong Ho Park, MD, PhD Department of Ophthalmology, Kyungpook National University Hospital, #130 Dongdeok-ro, Jung-gu, Daegu 700-721, Korea, Tel: 82-53-200-5806, Fax: 82-53-426-6552 E-mail: Sarasate2222@hanmail.net

Received 2 August 20137 October 2013 Accepted 17 February 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To measure the diameter of the retinal arterial and venous caliber of normal Korean subjects and evaluate the factors affecting these diameters.

Methods

Fundus photography was performed on 152 normal Korean subjects. Central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) were measured with a computer-based program (IVAN), and were used to investigate the relationship between the diameter and factors including age, gender, hypertension, diabetes, and smoking.

Results

Among the study subjects, the CRVE was 209.33 ± 12.40 μm and the CRAE was 149.70 ± 9.01 μm. The CRVE and CRAE decreased with increasing age in all study subjects (both p < 0.001). There were significant gender differences in the CRVE and CRAE (p = 0.002, p = 0.042, respectively). After adjusting for age and gender, the hypertension group showed smaller CRVE and CRAE than the non-hypertension group (p = 0.038, p = 0.032, respectively). Smoking and diabetes were not significant factors affecting the CRAE and CRVE (both p > 0.05).

Conclusions

In our study group, retinal vascular caliber of normal Korean subjects decreased with aging. Retinal vascular caliber was affected by gender and hypertension, but not by smoking and diabetes.

Keywords: Central retinal artery equivalent, Central retinal vein equivalent, Retinal vascular caliber, Retinal vessel diameter

References

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Figure 1.

Fundus photograph centered at the optic disc of right eye, grader analysis measures arteries and veins, the largest six arteries (red) and veins (blue) are used to calculate the central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) by the “Big 6” method. Yellow line is the vessel indicator of the IVAN. DD = disc diameter.

Figure 2.

(A) Central retinal vein caliber (CRVE) for all participants at a given age, (B) Central artery caliber (CRAE) for all participants at a given age. Scattering plot shows negative correlation with age and retinal vascular caliber.

Table 1.

Demographic characteristics of study participants stratified by age group

Age group (years)	20-29	30-39	40-49	50-59	60-69	70-79	All	p-value
Number of patients	54	26	18	26	18	10	152
Sex (male:female)	35:19	14:12	8:10	13:13	8:10	5:5	83:69	0.537^*
HTN (n (%))	0	0	2 (11.1)	8 (30.8)	11 (61.1)	5 (50.0)	26 (17.1)	<0.001^†
DM (n (%))	0	0	2 (11.1)	2 (7.7)	4 (22.2)	4 (40.0)	12 (7.9)	<0.001^†
Smoker (n (%))	4 (7.4)	4 (15.4)	2 (11.1)	4 (15.4)	5 (27.8)	1 (10.0)	20 (13.2)	0.363^†
Axial length (mm)	24.01 ± 0.99	24.24 ± 0.60	23.94 ± 0.52	23.89 ± 0.57	23.78 ± 0.32	23.91 ± 0.47	23.97 ± 0.67	0.425^‡

Values are presented as mean ± SD.

HTN = hypertension; DM = diabetes mellitus.

^* Comparison among age groups by Chi-square test

^† Fisher's exact test

^‡ ANOVA test.

Table 2.

Comparison of retinal vascular calibers with age group

	Age group (years)	CRVE (μm)	CRAE (μm)	AVR
All	20-29	212.36 ± 12.34	152.18 ± 9.11	0.72 ± 0.05
	30-39	211.14 ± 13.95	151.04 ± 9.93	0.72 ± 0.04
	40-49	210.34 ± 10.32	149.50 ± 7.36	0.71 ± 0.03
	50-59	207.53 ± 12.01	148.61 ± 7.56	0.72 ± 0.04
	60-69	204.60 ± 8.86	146.28 ± 9.01	0.72 ± 0.04
	70-79	199.59 ± 8.86	142.18 ± 7.28	0.71 ± 0.02
	Total	209.33 ± 12.19	149.70 ± 9.01	0.72 ± 0.04
	p-value^*	<0.001	<0.001	0.657
Male	20-29	214.25 ± 10.12	152.98 ± 8.41	0.72 ± 0.04
	30-39	213.65 ± 11.95	151.61 ± 10.28	0.71 ± 0.05
	40-49	213.31 ± 8.06	150.92 ± 7.10	0.71 ± 0.02
	50-59	210.98 ± 9.08	150.09 ± 7.01	0.71 ± 0.03
	60-69	207.04 ± 9.75	147.66 ± 8.33	0.71 ± 0.05
	70-79	203.27 ± 6.54	144.04 ± 6.28	0.71 ± 0.01
	Total	212.19 ± 10.14	151.05 ± 8.44	0.71 ± 0.04
	p-value^*	0.016	0.012	0.827
Female	20-29	208.88 ± 15.34	150.69 ± 10.35	0.72 ± 0.05
	30-39	208.21 ± 16.00	150.37 ± 9.91	0.72 ± 0.03
	40-49	207.96 ± 11.68	148.37 ± 7.75	0.71 ± 0.03
	50-59	204.09 ± 13.86	147.13 ± 8.07	0.72 ± 0.04
	60-69	202.65 ± 8.06	145.17 ± 9.81	0.72 ± 0.03
	70-79	195.91 ± 9.99	140.32 ± 8.44	0.72 ± 0.02
	Total	205.88 ± 13.55	148.07 ± 9.45	0.72 ± 0.04
	p-value^*	0.048	0.023	0.26

Values are presented as mean ± SD.

CRVE = central retinal vein equivalent; CRAE = central retinal artery equivalent; AVR = arteriovenous ratio.

^* Comparison among age groups by Jonckheere-Terpstra test.

Table 3.

Relationship of retinal vascular calibers with association factors

	CRVE (μm)			CRAE (μm)			AVR
HTN (yes/no)	203.93 ± 2.60		209.65 ±2.31	146.44 ± 1.93	1	150.82 ± 1.72	0.71 ± 0.0	05 0	.72 ± 0.04
p-value^*		0.038			0.032			0.988
DM (yes/no)	205.20 ± 3.52		208.38 ± 1.69	148.30 ± 2.61		148.96 ± 1.26	0.72 ± 0.0	04 0	.72 ± 0.05
p-value^*		0.393			0.811			0.985
p-value Smoker/non smoker	208.08 ± 3.04	0.393 2	205.50 ± 1.97	149.68 ± 2.26	0.811	147.59 ± 1.46	0.72 ± 0.0	0.98504 0	.72 ± 0.04
p-value^*		0.403			0.361			0.994

Values are presented as mean ± SD.

HTN = hypertension; DM = diabetes mellitus; CRVE = central retinal vein equivalent; CRAE = central retinal artery equivalent; AVR = arteriovenous ratio.

^* Using ANCOVA with adjustment for age, sex, hypertension, diabetic mellitus, smoking.

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