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Original Investigation | Epidemiology

Cross-sectional Associations of Medication and Supplement Use With Retinal Vascular Diameter in the Beaver Dam Eye Study

Kerri P. Howard, MS1; Barbara E. K. Klein, MD, MPH1; Jennifer O. Dreyer, BS1; Lorraine G. Danforth, BS1; Ronald Klein, MD, MPH1
[+] Author Affiliations
1Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison
JAMA Ophthalmol. 2014;132(1):23-31. doi:10.1001/jamaophthalmol.2013.6326.
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Importance  Retinal vessel diameters are being measured to examine their relationship with ocular and systemic disease and, in some studies, to calculate the risk of disease. Important factors that directly affect retinal vessel diameters, such as medication use, should be considered when estimating these associations.

Objective  To quantify the association between selected medications and supplements and retinal vessel diameters.

Design, Setting, and Participants  In a prospective cohort investigation, 4926 participants (aged 43-86 years at baseline) in the Beaver Dam Eye Study were evaluated every 5 years during 20 years of follow-up from 1988 to 2010.

Main Outcomes and Measures  Central retinal arteriolar equivalent and central retinal venular equivalent measured from the Early Treatment Diabetic Retinopathy Study fundus photograph field 1.

Results  After Bonferroni correction, the use of any blood pressure medication (β = 0.75; P = .04), specifically calcium channel blockers (β = −1.02; P < .001), was significantly associated with wider central retinal arteriolar equivalent adjusting for refraction, photograph focus, age, systolic blood pressure, height, examination phase, educational level, smoking and drinking histories, and presence of diabetes mellitus and emphysema. Use of prostaglandin analogues was marginally associated with narrower central retinal arteriolar equivalent (β = −2.04; P = .09); β-blockers (β = −1.02; P = .10) and oral corticosteroids (β = 2.13; P = .07) were marginally associated with changes in the central retinal venular equivalent.

Conclusions and Relevance  Several medications are associated with central retinal arteriolar and venular equivalents. Prostaglandin analogues, calcium channel blockers, and oral corticosteroids have the largest relative effects. After Bonferroni correction was applied, the use of calcium channel blockers was most strongly associated with change in the central retinal arteriolar equivalent. The presence of factors that are associated with retinal vessel diameters should be considered when using retinal vessel diameter as an outcome or when using these measures to assess the risk of systemic or ocular disease.

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