Retinal Microvascular Abnormalities tied to increased risks of all-cause and CVD mortality, suggests study
Researchers have discovered that retinal microvascular abnormalities (RMA) are independently associated with all-cause cardiovascular disease (CVD), and other-cause mortality among adults aged 40 years or older. Subtypes of RMA include retinopathy, arteriovenous nicking (AVN), focal arteriolar narrowing (FAN), and Hollenhorst plaque (HP), which correspond to cumulative damage from systemic diseases and aging. A recent study was conducted by Xiaoyun Chen and colleagues which was published in the journal of BMC Public Health.
A total of 5775 adults aged ≥40 years from NHANES, 2005–2008, were selected, and RMA and its subtypes were manually graded based on retinal photographs. This included 2881 women weighted at 52.6%, 2894 men weighted at 47.4%, and weighted mean age 56.6 years. Multivariable-adjusted Cox regression was used for evaluating the relationship between RMA and mortality, while controlling confounding factors. Participants were followed for a median of 12.2 years with 1488 deaths observed during this time.
Key Findings
Prevalence of RMA:
RMA was present in 17.9% of participants (weighted).
Retinopathy: 9.8% (weighted).
AVN: 9.3% (weighted).
FAN: 1.0% (weighted).
HP: 0.3% (weighted).
Mortality Rates and Associations:
Among 1488 deaths, 452 due to CVD, 341 due to cancer, and 695 other causes.
RMA was related with increased hazards for all-cause mortality (HR 1.26; 95% CI 1.07–1.47), CVD mortality (HR 1.36; 95% CI 1.06–1.73), and other-cause mortality (HR 1.33; 95% CI 1.06–1.67).
Retinopathy in particular was associated with increased hazards of all-cause mortality (HR 1.36; 95% CI 1.09–1.71), CVD mortality (HR 1.53; 95% CI 1.04–2.26), and other-cause mortality (HR 1.55; 95% CI 1.20–2.01).
FAN was strongly related to other-cause mortality (HR 2.06; 95% CI 1.16–3.65).
Subgroup Analysis:
AVN was not related to mortality in the general population.
Among obese individuals, AVN was associated with an increased risk of all-cause mortality (HR 1.68; 95% CI 1.12–2.52) and CVD mortality (HR 1.96; 95% CI 1.23–3.13).
This study showed that RMA is independently associated with increased risks of all-cause, CVD, and other-cause mortality in U.S. adults aged 40 years or older. The findings point out the prognostic value of RMA in predicting long-term survival and underscore the importance of integrating retinal health into broader cardiovascular and systemic disease management strategies.
Reference:
Chen, X., Si, H., Fu, Y. et al. Association of retinal microvascular abnormalities with all-cause and specific-cause mortality among U.S. adults. BMC Public Health 24, 3572 (2024). https://doi.org/10.1186/s12889-024-21117-0
