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Retina abnormalities associated with increased risk for PAD, CLI

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Small abnormalities in the retina were associated with a significant increase in risk for development of peripheral artery disease and critical limb ischemia, according to research presented at the American Heart Association’s Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions.

Chao Yang, MSc, from Johns Hopkins Bloomberg School of Public Health, and colleagues analyzed participants (n = 9,390) from the ARIC cohort study who had retinal photographs taken and no history of PAD.

Retinopathy was defined as microaneurysm, hemorrhages, soft or hard exudates, intraretinal microvascular abnormalities, venous beading, new vessels on the disc or elsewhere, fibrous proliferation, papillary swelling or laser photocoagulation.

During a mean follow-up of 19 years, 304 participants developed PAD as confirmed through diagnosis or revascularization and 92 participants developed CLI.

After adjusting for risk factors, the researchers found that when scans showed retinopathy, there was an increased risk for PAD (HR = 2.16; 95% CI, 1.6-2.92) and CLI (HR = 3.41; 95% CI, 2.15-5.41). Elevated risk for PAD or CLI was significantly associated with any form of hemorrhages, exudates and microaneurysms except flame-shaped hemorrhages.

For overall retinopathy and all forms of retinopathy, the relationship was stronger with CLI than with PAD, according to the researchers.

No significant association was found between arteriole wall findings and PAD or CLI.

Yang and colleagues also found that participants with diabetes tended to have stronger associations with PAD outcomes than those without.

The researchers concluded that the findings suggest the importance of microvascular wall fragility and permeability in the development of PAD. – by Cassie Homer

Reference:

Yang C, et al. Poster P243. Presented at: Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions; March 7-10, 2017; Portland, Ore.

Disclosure: The researchers report no relevant financial disclosures.