Diabetic neuropathy, nephropathy and retinopathy cause significant morbidity in patients with type 1 diabetes, even though improvements in treatment modalities delay the appearance and reduce the severity of these complications. To prevent or further delay the onset, it is necessary to better understand common underlying pathogenesis and to discover pre-clinical biomarkers of these complications.
Retinal vessel calibers have been associated with the presence of microvascular complications but their long-term predictive value has only been sparsely investigated.
We examined retinal vessel calibers as 16-year predictors of diabetic nephropathy, neuropathy and proliferative retinopathy in a young population-based Danish cohort with type 1 diabetes. We used semi-automated computer software to analyze vessel diameters on baseline retinal photos. Calibers of all vessels coursing through a zone 0.5-1 disc diameter from the disc margin were measured and summarized as the central artery and vein equivalents.
In multiple regression analyzes we found both wider venular diameters and smaller arteriolar diameters to be predictive of the 16-year development of nephropathy, neuropathy and proliferative retinopathy. Early retinal vessel caliber changes are seemingly early markers of microvascular processes, precede the development of microvascular complications and a potential non-invasive predictive test on future risk of diabetic retinopathy, neuropathy and nephropathy.
- Received February 10, 2014.
- Accepted June 1, 2014.
- © 2014 by the American Diabetes Association.
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