Long-term changes in retinal vascular diameter and cognitive impairment in type
1 diabetes.
Authors Nunley KA, Metti AL, Klein R, Klein BE, Saxton JA, Orchard TJ, Costacou T,
Aizenstein HJ, Rosano C
Submitted By Karen Nunley on 11/6/2018
Status Published
Journal Diabetes & vascular disease research
Year 2018
Date Published 5/1/2018
Volume : Pages 15 : 223 - 232
PubMed Reference 29488397
Abstract To assess associations between cognitive impairment and longitudinal changes in
retinal microvasculature, over 18 years, in adults with type 1 diabetes.,
Participants of the Pittsburgh Epidemiology of Diabetes Complications Study
received =3 fundus photographs between baseline (1986-1988) and time of
cognitive assessment (2010-2015: N = 119; 52% male; mean age and type 1 diabetes
duration 43 and 34 years, respectively). Central retinal arteriolar equivalent
and central retinal venular equivalent were estimated via computer-based
methods; overall magnitude and speed of narrowing were quantified as cumulative
average and slope, respectively. Median regression models estimated associations
of central retinal arteriolar equivalent and central retinal venular equivalent
measures with cognitive impairment status, adjusted for type 1 diabetes
duration. Interactions with HbA1c, proliferative retinopathy and white matter
hyperintensities were assessed., Compared with participants without cognitive
impairment, those with clinically relevant cognitive impairment experienced 1.8%
greater and 31.1% faster central retinal arteriolar equivalent narrowing during
prior years (t = -2.93, p = 0.004 and t = -3.97, p < 0.0001, respectively).
Interactions with HbA1c, proliferative retinopathy and white matter
hyperintensities were not significant. No associations were found between
central retinal arteriolar equivalent at baseline, at time of cognitive testing,
or any central retinal venular equivalent measures, and cognitive impairment.,
Long-term arterial retinal changes could indicate type 1 diabetes-related
cognitive impairment. Studies examining longitudinal central retinal arteriolar
equivalent changes as early biomarkers of cognitive impairment risk are
warranted.

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