Retinal Vascular Changes in Pre-Diabetes and Prehypertension
Open accessAbstract
The retinal vasculature can be viewed directly and noninvasively, offering a unique and easily accessible “window” to study the health and disease of the human microcirculation in vivo. In the last decade, advances in digital retinal photography and imaging techniques have allowed precise characterization of subtle retinal vascular changes in large populations. These retinal changes can be broadly divided into four groups: 1 ) classic retinal vascular changes in diabetes and hypertension (i.e., diabetic and hypertensive retinopathy), 2 ) isolated retinopathy signs in individuals with diabetes or hypertension (e.g., microaneurysm, retinal hemorrhage, or cotton wool spot), 3 ) changes in retinal vascular caliber, and 4 ) changes in retinal vascular architecture (e.g., retinal tortuosity). New studies in large populations now show that retinal vascular changes are common in the general population and may precede the subsequent development of overt diabetes and hypertension. A consistent pattern of associations is also emerging, showing that specific retinal vascular changes may be related differently to hyperglycemia and blood pressure. In this review, we summarize recent studies on the retinal vascular changes seen in diabetes and hypertension and speculate on potential research and clinical implications. ### Diabetic retinopathy In individuals with diabetes, the classic primary retinal vascular complication—diabetic retinopathy—is well described (1). Diabetic retinopathy signs are broadly divided into nonproliferative and proliferative retinopathy. The prevalence of diabetic retinopathy increases with duration of diabetes. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) showed that the prevalence of diabetic retinopathy is less than 10% in those with diabetes duration of less than 5 years but more than 50% in those with 20 years or longer diabetes (2). The two major risk factors of diabetic retinopathy are hyperglycemia and hypertension, with hyperlipidemia as a possible third major risk factor. The importance of hyperglycemia has been confirmed in epidemiological studies (3), as well as two pivotal …
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Prediabetes status may be associated with an increased risk of diabetic retinopathy, although findings vary depending on the method of detection.
“Prediabetes status may be associated with an increased risk of diabetic retinopathy although the findings vary depending on the method of detection.51,79–83”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [81]
Measures of retinal vascular changes, such as lower arteriole-to-venule ratio and increased retinal arteriole or venular calibre, have been shown to be related to prediabetes or increased risk of diabetes, but the evidence is not entirely consistent.
“Measures of retinal vascular changes, such as lower arteriole-to-venule ratio, increased retinal arteriole or venular calibre, have also been shown to be related to prediabetes or increased risk of diabetes, but the evidence is not entirely consistent.81–83”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [81]
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Cites
(1993) · New England Journal of Medicine · doi:10.1056/nejm199309303291401 · Cited by 24,667 · see citing works
Stearne, M. R., Palmer, S. L., Hammersley, M. S., Franklin, S. L., Spivey, R. S., Lévy, J., Tidy, C. R., Bell, N. J., Steemson, J., Barrow, B. A., et al. (1998) · UCL Discovery (University College London) · Cited by 4,803 · see citing works
Barker, D. J., Osmond, C., Golding, J., Kuh, D., & Wadsworth, M. E. (1989) · BMJ · doi:10.1136/bmj.298.6673.564 · Cited by 2,415 · see citing works
(1999) · The Lancet · doi:10.1016/s0140-6736(98)12131-1 · Cited by 1,313 · see citing works
Onset of NIDDM occurs at Least 4–7 yr Before Clinical Diagnosis
Harris, M. I., Klein, R., Welborn, T. A., & Knuiman, M. W. (1992) · Diabetes Care · doi:10.2337/diacare.15.7.815 · Cited by 1,306 · see citing works
Borch‐Johnsen, K., Neil, A., Balkau, B., Larsen, S. H., Nissinen, A. E. T., Pekkanen, J., Keinanen-Kiukaanniemi, S. M., Hiltunen, L. A., Kivelä, S., Tuomilehto, J. O., et al. (1999) · The Lancet · Cited by 1,272 · see citing works
Leibowitz, H. M., Krueger, D. E., Maunder, L. R., Milton, R. C., KINI, M. M., Kahn, H. A., Nickerson, R. J., Pool, J., Colton, T., Ganley, J. P., et al. (1980) · PubMed · Cited by 1,250 · see citing works
Hubbard, L. D., Brothers, R. J., King, W. N., Clegg, L. X., Klein, R., Cooper, L. S., Sharrett, A. R., Davis, M. D., & Cai, J. (1999) · Ophthalmology · doi:10.1016/s0161-6420(99)90525-0 · Cited by 1,212 · see citing works
A central role for inflammation in the pathogenesis of diabetic retinopathy
Joussen, A. M., Poulaki, V., Le, M. L., Koizumi, K., Esser, C., Janicki, H., Schraermeyer, U., Kociok, N., Fauser, S., Kirchhof, B., et al. (2004) · The FASEB Journal · doi:10.1096/fj.03-1476fje · Cited by 1,178 · see citing works
Diabetic Retinopathy and Diabetic Macular Edema
Ciulla, T. A., Amador, A. G., & Zinman, B. (2003) · Diabetes Care · doi:10.2337/diacare.26.9.2653 · Cited by 836 · see citing works
Retinal Arteriolar Narrowing and Risk of Coronary Heart Disease in Men and Women
Wong, T. Y., Klein, R., Sharrett, A. R., Duncan, B. B., Couper, D. J., Tielsch, J. M., Klein, R., & Hubbard, L. D. (2002) · JAMA · doi:10.1001/jama.287.9.1153 · Cited by 797 · see citing works
Self-citationMiyamoto, K., Khosrof, S., Bursell, S., Rohan, R. M., Murata, T., Clermont, A. C., Aiello, L. P., Ogura, Y., & Adamis, A. P. (1999) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.96.19.10836 · Cited by 787 · see citing works
Wong, T. Y., Klein, R., Couper, D. J., Cooper, L. S., Shahar, E., Hubbard, L. D., Wofford, M. R., & Sharrett, A. R. (2001) · The Lancet · doi:10.1016/s0140-6736(01)06253-5 · Cited by 783 · see citing works
Self-citationWong, T. Y., & Mitchell, P. (2004) · New England Journal of Medicine · doi:10.1056/nejmra032865 · Cited by 703 · see citing works
Self-citationDiabetic Retinopathy in a Multi-ethnic Cohort in the United States
Wong, T. Y., Klein, R., Islam, A. F. M., Cotch, M. F., Folsom, A. R., Klein, B. E. K., Sharrett, A. R., & Shea, S. (2006) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2005.08.063 · Cited by 686 · see citing works
Self-citationRetinal image analysis: Concepts, applications and potential
Patton, N., Aslam, T. M., MacGillivray, T., Deary, I. J., Dhillon, B., Eikelboom, R. H., Kanagasingam, Y., & Constable, I. J. (2005) · Progress in Retinal and Eye Research · doi:10.1016/j.preteyeres.2005.07.001 · Cited by 640 · see citing works
Wong, T. Y., Islam, A. F. M., Klein, R., Klein, R., Cotch, M. F., Castro‐Diehl, C., Sharrett, A. R., & Shahar, E. (2006) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.05-1539 · Cited by 626 · see citing works
Self-citationGirard, B. (2008) · Cited by 618 · see citing works
Wong, T. Y., & Mitchell, P. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60198-6 · Cited by 589 · see citing works
Self-citationRole of COL4A1 in Small-Vessel Disease and Hemorrhagic Stroke
Gould, D. B., Phalan, F. C., van Mil, S. E., Sundberg, J. P., Vahedi, K., Massin, P., Bousser, M. G., Heutink, P., Miner, J. H., Tournier-Lasserve, E., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa053727 · Cited by 581 · see citing works
Glycosylated Hemoglobin Predicts the Incidence and Progression of Diabetic Retinopathy
Klein, R. (1988) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.260.19.2864 · Cited by 528 · see citing works
Glycosylated Hemoglobin Predicts the Incidence and Progression of Diabetic Retinopathy
Klein, R. (1988) · JAMA · doi:10.1001/jama.1988.03410190112033 · Cited by 517 · see citing works
Ikram, M. K., de Jong, F. J., Vingerling, J. R., Witteman, J. C. M., Albert Hofman, D., Breteler, M. M. B., & de Jong, P. T. V. M. (2004) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.03-1390 · Cited by 500 · see citing works
Cerebral White Matter Lesions, Retinopathy, and Incident Clinical Stroke
Wong, T. Y. (2002) · JAMA · doi:10.1001/jama.288.1.67 · Cited by 486 · see citing works
Self-citationWong, T. Y. (2004) · Ophthalmology · doi:10.1016/j.ophtha.2003.09.039 · Cited by 446 · see citing works
Self-citationThe Prevalence of and Factors Associated With Diabetic Retinopathy in the Australian Population
Tapp, R. J., Shaw, J. E., Harper, C. A., de Courten, M., Balkau, B., McCarty, D. J., Taylor, H. R., Welborn, T. A., Zimmet, P., & on behalf of the AusDiab Study Group (2003) · Diabetes Care · doi:10.2337/diacare.26.6.1731 · Cited by 439 · see citing works
Blood Pressure, Lipids, and Obesity Are Associated With Retinopathy
van Leiden, H. A., Dekker, J. M., Moll, A. C., Nijpels, G., Heine, R. J., Bouter, L. M., Stehouwer, C. D. A., & Polak, B. C. P. (2002) · Diabetes Care · doi:10.2337/diacare.25.8.1320 · Cited by 414 · see citing works
Pathophysiology of Hypertensive Retinopathy
Tso, M. O. M., & Jampol, L. M. (1982) · Ophthalmology · doi:10.1016/s0161-6420(82)34663-1 · Cited by 397 · see citing works
Witt, N., Wong, T. Y., Hughes, A. D., et al. (2006) · Hypertension · doi:10.1161/01.hyp.0000216717.72048.6c · Cited by 375 · see citing works
Self-citationDiabetes Prevention Program Research Group (2007) · Diabetic Medicine · doi:10.1111/j.1464-5491.2007.02043.x · Cited by 363 · see citing works
Retinal microvascular abnormalities and 10-year cardiovascular mortality
Wong, T. Y., Klein, R., Nieto, F. J., Klein, B. E. K., Sharrett, A. R., Meuer, S. M., Hubbard, L. D., & Tielsch, J. M. (2003) · Ophthalmology · doi:10.1016/s0161-6420(03)00084-8 · Cited by 349 · see citing works
Self-citationSharrett, A. R., Hubbard, L. D., Cooper, L. S., Sorlie, P. D., Brothers, R. J., Nieto, F. J., Pinsky, J. L., & Klein, R. (1999) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009997 · Cited by 348 · see citing works
Retinal Vessel Diameters and Risk of Hypertension
Ikram, M. K., Witteman, J. C. M., Vingerling, J. R., Breteler, M. M. B., Albert Hofman, D., & de Jong, P. T. V. M. (2005) · Hypertension · doi:10.1161/01.hyp.0000199104.61945.33 · Cited by 341 · see citing works
Retinal Vessel Diameters and Their Associations with Age and Blood Pressure
Wong, T. Y., Klein, R., Klein, B. E. K., Meuer, S. M., & Hubbard, L. D. (2003) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.03-0079 · Cited by 322 · see citing works
Self-citationRetinal arteriolar narrowing and risk of diabetes mellitus in middle-aged persons
Wong, T. Y. (2002) · JAMA · doi:10.1001/jama.287.19.2528 · Cited by 320 · cited 2× · see citing works
“27]; comparing smallest to largest AVR quartile) (64,65).”
BackgroundSelf-citationRetinal Arteriolar Diameter and Risk for Hypertension
Wong, T. Y., Klein, R., Sharrett, A. R., et al. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-4-200402170-00006 · Cited by 319 · see citing works
Self-citationAre Retinal Arteriolar Abnormalities Related to Atherosclerosis?
Klein, R., Sharrett, A. R., Klein, B. E. K., Chambless, L. E., Cooper, L. S., Hubbard, L. D., & Evans, G. (2000) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.20.6.1644 · Cited by 303 · see citing works
The prevalence and risk factors of retinal microvascular abnormalities in older persons
Wong, T. Y., Klein, R., Sharrett, A. R., Manolio, T. A., Hubbard, L. D., Marino, E. K., Kuller, L. H., Burke, G. L., Tracy, R. P., Polak, J. F., et al. (2003) · Ophthalmology · doi:10.1016/s0161-6420(02)01931-0 · Cited by 296 · see citing works
Self-citationQuantitative Retinal Venular Caliber and Risk of Cardiovascular Disease in Older Persons
Wong, T. Y. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.21.2388 · Cited by 295 · see citing works
Self-citationPrehypertension and Cardiovascular Disease Risk in the Women’s Health Initiative
Hsia, J. A., Margolis, K. L., Eaton, C. B., WENGER, N. K., Allison, M., Wu, L., LaCroix, A. Z., & Black, H. R. (2007) · Circulation · doi:10.1161/circulationaha.106.656850 · Cited by 288 · see citing works
Retinal vessel diameters and risk of stroke
Ikram, M. K., de Jong, F. J., Bos, M. J., et al. (2006) · Neurology · doi:10.1212/01.wnl.0000210533.24338.ea · Cited by 284 · see citing works
Wong, T. Y., Duncan, B. B., Golden, S. H., Klein, R., Couper, D. J., Klein, B. E. K., Hubbard, L. D., Sharrett, A. R., & Schmidt, M. I. (2004) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.04-0069 · Cited by 281 · see citing works
Self-citationRelationships between Age, Blood Pressure, and Retinal Vessel Diameters in an Older Population
Leung, H., Wang, J. J., Rochtchina, E., Tan, A. G., Wong, T. Y., Klein, R., Hubbard, L. D., & Mitchell, P. (2003) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.02-1114 · Cited by 281 · see citing works
Self-citationWong, T. Y. (2002) · British Journal of Ophthalmology · doi:10.1136/bjo.86.9.1007 · Cited by 272 · see citing works
Self-citationRetinal vessel diameters and cerebral small vessel disease: the Rotterdam Scan Study
Ikram, M. K., de Jong, F. J., van Dijk, E. J., Prins, N. D., Albert Hofman, D., Breteler, M. M. B., & de Jong, P. T. V. M. (2005) · Brain · doi:10.1093/brain/awh688 · Cited by 258 · see citing works
Prospective cohort study of retinal vessel diameters and risk of hypertension
Wong, T. Y., Shankar, A., Klein, R., et al. (2004) · BMJ · doi:10.1136/bmj.38124.682523.55 · Cited by 253 · see citing works
Self-citationRetinal Arteriolar Narrowing and Risk of Diabetes Mellitus in Middle-aged Persons
Bressler, N. M. (2003) · Archives of Ophthalmology · doi:10.1001/archopht.121.1.113 · Cited by 250 · see citing works
Retinal Microvascular Abnormalities and Cognitive Impairment in Middle-Aged Persons
Wong, T. Y., Klein, R., Sharrett, A. R., Nieto, F. J., Boland, L. L., Couper, D. J., Mosley, T. H., Klein, B. E. K., Hubbard, L. D., & Szklo, M. (2002) · Stroke · doi:10.1161/01.str.0000016789.56668.43 · Cited by 241 · see citing works
Self-citationRetinal Microvascular Abnormalities and Renal Dysfunction
Wong, T. Y., Coresh, J., Klein, R., Muntner, P., Couper, D. J., Sharrett, A. R., Klein, B. E. K., HEISS, G. M., Hubbard, L. D., & Duncan, B. B. (2004) · Journal of the American Society of Nephrology · doi:10.1097/01.asn.0000136133.28194.e4 · Cited by 233 · see citing works
Self-citationDiabetes, Hyperglycemia, and Inflammation in Older Individuals
de Rekeneire, N., Peila, R., Ding, J., Colbert, L. H., Visser, M., Shorr, R. I., Kritchevsky, S. B., Kuller, L. H., Strotmeyer, E. S., Schwartz, A. V., et al. (2006) · Diabetes Care · doi:10.2337/dc05-2327 · Cited by 230 · see citing works
Parr, J. C., & Spears, G. F. S. (1974) · American Journal of Ophthalmology · doi:10.1016/0002-9394(74)90457-7 · Cited by 229 · see citing works
Retinopathy and Risk of Congestive Heart Failure
Wong, T. Y. (2005) · JAMA · doi:10.1001/jama.293.1.63 · Cited by 226 · see citing works
Self-citationInflammation and endothelial dysfunction are associated with retinopathy: the Hoorn Study
van Hecke, M. V., Dekker, J. M., Nijpels, G., Moll, A. C., Heine, R. J., Bouter, L. M., Polak, B. C. P., & Stehouwer, C. D. A. (2005) · Diabetologia · doi:10.1007/s00125-005-1799-y · Cited by 219 · see citing works
Hypertension and Retinopathy, Arteriolar Narrowing, and Arteriovenous Nicking in a Population
Klein, R. (1994) · Archives of Ophthalmology · doi:10.1001/archopht.1994.01090130102026 · Cited by 219 · see citing works
Retinal microvascular signs and risk of stroke and stroke mortality
Mitchell, P., Wang, J. J., Wong, T. Y., Smith, W. T., Klein, R., & Leeder, S. (2005) · Neurology · doi:10.1212/01.wnl.0000179177.15900.ca · Cited by 215 · see citing works
Self-citationMiyarnoto, K. (1999) · Medical Entomology and Zoology · Cited by 207 · see citing works
Retinal Arteriolar Narrowing Is Associated With 5-Year Incident Severe Hypertension
Smith, W. T., Wang, J. J., Wong, T. Y., Rochtchina, E., Klein, R., Leeder, S., & Mitchell, P. L. R. (2004) · Hypertension · doi:10.1161/01.hyp.0000140772.40322.ec · Cited by 206 · see citing works
Self-citationVascular network changes in the retina with age and hypertension.
Stanton, A. V., Wasan, B. S., Cerutti, A., et al. (1995) · PubMed · Cited by 199 · see citing works
Hypertensive Retinal Vessel Wall Signs in a General Older Population
Wang, J. J., Mitchell, P., Leung, H., Rochtchina, E., Wong, T. Y., & Klein, R. (2003) · Hypertension · doi:10.1161/01.hyp.0000090122.38230.41 · Cited by 195 · see citing works
Self-citationEdwards, M. S., Wilson, D. B., Craven, T. E., Stafford, J. M., Fried, L. F., Wong, T. Y., Klein, R., Burke, G. L., & Hansen, K. J. (2005) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2005.05.005 · Cited by 193 · see citing works
Self-citationBlood Pressure and Retinal Arteriolar Narrowing in Children
Mitchell, P., Cheung, N., de Haseth, K., Taylor, B., Rochtchina, E., Islam, A. F. M., Wang, J. J., Saw, S., & Wong, T. Y. (2007) · Hypertension · doi:10.1161/hypertensionaha.106.085910 · Cited by 189 · see citing works
Self-citationThe Relation of Fasting and 2-h Postchallenge Plasma Glucose Concentrations to Mortality
Sorkin, J. D., Muller, D. C., Fleg, J. L., & Andres, R. (2005) · Diabetes Care · doi:10.2337/diacare.28.11.2626 · Cited by 189 · see citing works
Retinopathy in Older Persons Without Diabetes and Its Relationship to Hypertension
Yu, T. (1998) · Archives of Ophthalmology · doi:10.1001/archopht.116.1.83 · Cited by 183 · see citing works
Blood Pressure and Hypertensive Disease Among Negroes and Whites
McDonough, J. R., GARRISON, G. E., & HAMES, C. G. (1964) · Annals of Internal Medicine · doi:10.7326/0003-4819-61-2-208 · Cited by 177 · see citing works
Retinal vascular manifestations of metabolic disorders
Nguyen, T. T. L., & Wong, T. Y. (2006) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2006.07.006 · Cited by 171 · see citing works
Self-citationRetinal Vessel Diameters and Obesity: A Population‐Based Study in Older Persons
Wang, J. J., Taylor, B., Wong, T. Y., Chua, B., Rochtchina, E., Klein, R., & Mitchell, P. (2006) · Obesity · doi:10.1038/oby.2006.27 · Cited by 170 · see citing works
Self-citationKlein, R., Klein, R., & Moss, S. E. (1998) · American Journal of Ophthalmology · doi:10.1016/s0002-9394(99)80172-x · Cited by 167 · see citing works
Relation between blood glucose and coronary mortality over 33 years in the Whitehall Study
Brunner, E. J., Shipley, M. J., Witte, D. R., Fuller, J. H., & Marmot, M. G. (2006) · Diabetes Care · doi:10.2337/diacare.29.01.06.dc05-1405 · Cited by 166 · see citing works
Mathematic Relationships Between the width of a Retinal Artery and the Widths of its Branches
Parr, J. C., & Spears, G. F. S. (1974) · American Journal of Ophthalmology · doi:10.1016/0002-9394(74)90458-9 · Cited by 153 · see citing works
Impact of current and past blood pressure on retinal arteriolar diameter in an older population
Leung, H., Wang, J. J., Rochtchina, E., Wong, T. Y., Klein, R., & Mitchell, P. (2004) · Journal of Hypertension · doi:10.1097/01.hjh.0000125455.28861.3f · Cited by 151 · see citing works
Self-citationRetinal Arteriolar Narrowing, Hypertension, and Subsequent Risk of Diabetes Mellitus
Wong, T. Y. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.9.1060 · Cited by 150 · see citing works
Self-citationCouper, D. J., Klein, R., Hubbard, L. D., Wong, T. Y., Sorlie, P. D., Cooper, L. S., Brothers, R. J., & Nieto, F. J. (2002) · American Journal of Ophthalmology · doi:10.1016/s0002-9394(01)01315-0 · Cited by 149 · see citing works
Self-citationTotal retinal volumetric blood flow rate in diabetic patients with poor glycemic control.
Grunwald, J. E., Riva, C. E., Baine, J., et al. (1992) · PubMed · Cited by 147 · see citing works
Liew, G., Sharrett, A. R., Kronmal, R. A., et al. (2006) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.06-0672 · Cited by 147 · see citing works
Reliability of computer‐assisted retinal vessel measurement in a population
Sherry, L. M., Wang, J. J., Rochtchina, E., et al. (2002) · Clinical and Experimental Ophthalmology · doi:10.1046/j.1442-9071.2002.00520.x · Cited by 147 · see citing works
Self-citationKLEIN, R., KLEIN, B., Moss, S. E., Wong, T. Y., & SHARRETT, A. (2006) · Ophthalmology · doi:10.1016/j.ophtha.2006.03.028 · Cited by 146 · see citing works
Self-citationWalsh, J. B. (1982) · Ophthalmology · doi:10.1016/s0161-6420(82)34664-3 · Cited by 139 · see citing works
Retinal vascular abnormalities in persons with type 1 diabetes
Klein, R., Klein, B. E. K., Moss, S. E., Wong, T. Y., Hubbard, L. D., Cruickshanks, K. J., & Palta, M. (2003) · Ophthalmology · doi:10.1016/s0161-6420(03)00863-7 · Cited by 137 · see citing works
Self-citationWilkinson‐Berka, J. L. (2004) · Current Pharmaceutical Design · doi:10.2174/1381612043383142 · Cited by 136 · see citing works
Hypertensive retinopathy and incident coronary heart disease in high risk men
Duncan, B. B. (2002) · British Journal of Ophthalmology · doi:10.1136/bjo.86.9.1002 · Cited by 135 · see citing works
Retinal Vessel Diameters and Risk of Impaired Fasting Glucose or Diabetes
Ikram, M. K., Janssen, J. A. M. J. L., Roos, A. M. E., Rietveld, I., Witteman, J. C. M., Breteler, M. M. B., Albert Hofman, D., van Duijn, C. M., & de Jong, P. T. V. M. (2006) · Diabetes · doi:10.2337/diabetes.55.02.06.db05-0546 · Cited by 132 · see citing works
Automatic Grading of Retinal Vessel Caliber
Li, H., Hsu, W., Lee, M. L., et al. (2005) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2005.847402 · Cited by 130 · see citing works
Wong, T. Y., Shankar, A., Klein, R., & Klein, B. E. K. (2004) · Diabetes · doi:10.2337/diabetes.53.1.179 · Cited by 130 · see citing works
Self-citationAssociation of Carotid Intima-Media Thickness and Arterial Stiffness With Diabetic Retinopathy
Rema, M., Mohan, V., Deepa, R., & Ravikumar, R. (2004) · Diabetes Care · doi:10.2337/diacare.27.8.1962 · Cited by 121 · see citing works
Retinopathy, Glucose, and Insulin in an Elderly Population: The Rotterdam Study
Stolk, R. P., Vingerling, J. R., de Jong, P. T. V. M., Dielemans, I., Albert Hofman, D., Lamberts, S. W., Pols, H. A. P., & Grobbee, D. E. (1995) · Diabetes · doi:10.2337/diab.44.1.11 · Cited by 120 · see citing works
Hughes, A. D., Martinez-Perez, E., Jabbar, A.-S., et al. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000222759.61735.98 · Cited by 119 · see citing works
Incidence and predictors of hypertension over 8 years among Chinese men and women
Gu, D., Wildman, R. P., Wu, X., Reynolds, K., Huang, J., Chen, C.-S., & He, J. (2007) · Journal of Hypertension · doi:10.1097/hjh.0b013e328013e7f4 · Cited by 98 · see citing works
BMI and Retinal Vascular Caliber in Children
Cheung, N., Saw, S., Islam, A. F. M., Rogers, S., Shankar, A., de Haseth, K., Mitchell, P., & Wong, T. Y. (2007) · Obesity · doi:10.1038/oby.2007.576 · Cited by 96 · see citing works
Self-citationKawasaki, R., Wang, J.-J., Rochtchina, E., Taylor, B., Wong, T.-Y., Tominaga, M., Kato, T., Daimon, M., Oizumi, T., Kawata, S., et al. (2006) · Ophthalmology (Rochester, Minn.) · doi:10.1016/j.ophtha.2006.02.052 · Cited by 94 · see citing works
Self-citationHypertensive Eye Ground Changes
Svärdsudd, K., Wedel, H., Aurell, E., & Tibblin, G. (1978) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1978.tb08418.x · Cited by 90 · see citing works
Liesegang, T. J. (2002) · American Journal of Ophthalmology · doi:10.1016/s0002-9394(02)01606-9 · Cited by 87 · see citing works
Retinal microvascular changes and MRI signs of cerebral atrophy in healthy, middle-aged people
Wong, T. Y., Mosley, T. H., Klein, R., Klein, R., Sharrett, A. R., Couper, D. J., & Hubbard, L. D. (2003) · Neurology · doi:10.1212/01.wnl.0000086372.05488.8d · Cited by 85 · see citing works
Self-citationKlein, R., Klein, R., Moss, S. E., & Wong, T. Y. (2006) · Europe PMC (PubMed Central) · Cited by 84 · see citing works
Self-citationAre vascular abnormalities a primary cause or secondary consequence of hypertension?
Mulvany, M. J. (1991) · Hypertension · doi:10.1161/01.hyp.18.3_suppl.i52 · Cited by 84 · see citing works
Ling, P., Mueller, C., Smith, R. J., & Bistrian, B. R. (2003) · Metabolism · doi:10.1016/s0026-0495(03)00057-x · Cited by 83 · see citing works
Caballero, A. E. (2005) · Archives of Medical Research · doi:10.1016/j.arcmed.2005.03.013 · Cited by 82 · see citing works
Cheung, N., Islam, A. F. M., Saw, S., Shankar, A., de Haseth, K., Mitchell, P., & Wong, T. Y. (2007) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.06-0978 · Cited by 78 · see citing works
Self-citationCugati, S., Cikamatana, L., Wang, J. J., Kifley, A., Liew, G., & Mitchell, P. (2005) · Eye · doi:10.1038/sj.eye.6702085 · Cited by 74 · see citing works
Self-citationGrossniklaus, H. E. (2002) · American Journal of Ophthalmology · doi:10.1016/s0002-9394(02)01785-3 · Cited by 73 · see citing works
Wong, T. Y., Barr, E., Tapp, R. J., Harper, C. A., Taylor, H. R., Zimmet, P., & Shaw, J. E. (2005) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2005.07.030 · Cited by 73 · see citing works
Self-citationGenome-Wide Linkage Study of Retinal Vessel Diameters in the Beaver Dam Eye Study
Xing, C., Klein, B. E. K., Klein, R., et al. (2006) · Hypertension · doi:10.1161/01.hyp.0000208330.68355.72 · Cited by 72 · see citing works
Do retinopathy signs in non-diabetic individuals predict the subsequent risk of diabetes?
Wong, T. Y. (2006) · British Journal of Ophthalmology · doi:10.1136/bjo.2005.084400 · Cited by 67 · see citing works
Self-citationPediatric Antecedents of Adult Cardiovascular Disease — Awareness and Intervention
Ingelfinger, J. R. (2004) · New England Journal of Medicine · doi:10.1056/nejmp048069 · Cited by 62 · see citing works
Vascular network changes in the retina with age and hypertension
Wasan, B. S., Cerutti, A., Ford, S., et al. (1995) · Journal of Hypertension · doi:10.1097/00004872-199512010-00039 · Cited by 61 · see citing works
Chester, A. H. (1998) · Cardiovascular Research · doi:10.1016/s0008-6363(98)00054-6 · Cited by 58 · see citing works
Wong, T. Y., Klein, R., Islam, A. F. M., Cotch, M. F., Couper, D. J., Klein, B. E. K., Hubbard, L. D., & Sharrett, A. R. (2007) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2007.02.020 · Cited by 56 · see citing works
Self-citationAre Narrower or Wider Retinal Venules Associated With Incident Hypertension?
Liew, G., Wong, T. Y., Mitchell, P., & Wang, J. J. (2006) · Hypertension · doi:10.1161/01.hyp.0000231652.97173.4c · Cited by 54 · see citing works
Self-citationRacial Differences in the Prevalence of Hypertensive Retinopathy
Wong, T. Y., Klein, R., Duncan, B. B., et al. (2003) · Hypertension · doi:10.1161/01.hyp.0000064181.63546.53 · Cited by 53 · see citing works
Self-citationHypertensive Retinopathy in Afro-Caribbeans and Europeans
Sharp, P. S., Chaturvedi, N., Wormald, R., McKeigue, P., Marmot, M. G., & Young, S. M. (1995) · Hypertension · doi:10.1161/01.hyp.25.6.1322 · Cited by 53 · see citing works
Microcirculatory changes during chronic adaptation to hypoxia
Saldı́var, E., Cabrales, P., Tsai, A. G., et al. (2003) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00349.2003 · Cited by 52 · see citing works
King, L. A., Stanton, A. V., Sever, P., et al. (1996) · PubMed · Cited by 50 · see citing works
Grossniklaus, H. E. (2002) · American Journal of Ophthalmology · doi:10.1016/s0002-9394(02)01716-6 · Cited by 50 · see citing works
Patton, N., Aslam, T. M., MacGillivray, T., et al. (2006) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.05-1248 · Cited by 43 · see citing works
Wagener, H. P., Clay, G. E., & Gipner, J. F. (1947) · PubMed · Cited by 42 · see citing works
Lipid Hydroperoxide Stimulates Leukocyte–Endothelium Interaction in the Retinal Microcirculation
Tamai, K., Matsubara, A., Tomida, K., et al. (2002) · Experimental Eye Research · doi:10.1006/exer.2002.1178 · Cited by 38 · see citing works
Retinopathy, glucose, and insulin in an elderly population. The Rotterdam Study
Stolk, R. P., Vingerling, J. R., de Jong, P. T. V. M., et al. (1995) · Diabetes · doi:10.2337/diabetes.44.1.11 · Cited by 37 · see citing works
Inflammatory Markers and Diabetic Retinopathy in Type 1 Diabetes
Izuora, K. E., Chase, H. P., Jackson, W. E., et al. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.714 · Cited by 31 · see citing works
Genetic Determinants of Retinal Vascular Caliber
Wang, J. J., & Wong, T. Y. (2006) · Hypertension · doi:10.1161/01.hyp.0000208303.74884.78 · Cited by 28 · see citing works
Self-citationLPS-induced microvascular leukocytosis can be assessed by blue-field entoptic phenomenon
Kolodjaschna, J., Berisha, F., Lung, S., et al. (2004) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.01240.2003 · Cited by 25 · see citing works
Familial Retinal Arterial Tortuosity Associated With Tortuosity in Nail Bed Capillaries
Gekeler, F. (2006) · Archives of Ophthalmology · doi:10.1001/archopht.124.10.1492 · Cited by 19 · see citing works
Assessment of retinal vascular changes in hypertension: new perspectives
Muiesan, M. L., & Grassi, G. M. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000222747.59949.05 · Cited by 18 · see citing works
Retinal capillary density in patients with arterial hypertension: 2-year follow-up
Kutschbach, P., Wolf, S., Sieveking, M., et al. (1998) · Graefe s Archive for Clinical and Experimental Ophthalmology · doi:10.1007/s004170050098 · Cited by 17 · see citing works
Hemiretinal arterial supply by the cilioretinal artery
Lewis, A. M., & Mireskandari, K. (2004) · Eye · doi:10.1038/sj.eye.6701750 · Cited by 12 · see citing works
Do retinopathy signs in non-diabetic individuals predict the subsequent risk of diabetes?
Cugati, S., Mitchell, P., & Wang, J. J. (2006) · British Journal of Ophthalmology · doi:10.1136/bjo.2006.095943 · Cited by 8 · see citing works
Self-citationAre Inflammatory Factors Related to Retinal Vessel Caliber?
Klein, R. (2006) · Archives of Ophthalmology · doi:10.1001/archopht.124.1.87 · Cited by 1 · see citing works
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Prediabetes: a high-risk state for diabetes development
Tabák, A. G., Herder, C., Rathmann, W., Brunner, E. J., & Kivimäki, M. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60283-9 · Cited by 2,958 · see citing works
Prediabetes diagnosis and treatment: A review
Bansal, N. (2015) · World Journal of Diabetes · doi:10.4239/wjd.v6.i2.296 · Cited by 579 · see citing works
A new look at screening and diagnosing diabetes mellitus
Saudek, C. D., Herman, W. H., Sacks, D. B., Bergenstal, R. M., Edelman, D., & Davidson, M. B. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-2174 · Cited by 432 · see citing works
Retinal Arteriolar Narrowing Predicts Incidence of Diabetes
Nguyen, T. T., Wang, J. J., Islam, F. M. A., Mitchell, P., Tapp, R. J., Zimmet, P. Z., Simpson, R., Shaw, J., & Wong, T. Y. (2008) · Diabetes · doi:10.2337/db07-1376 · Cited by 112 · see citing works
Self-citationPopulation-Based Studies in Ophthalmology
Wong, T. Y., & Hyman, L. (2008) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2008.07.048 · Cited by 74 · see citing works
Self-citationWang, Y., Yuan, Y., Zhang, Y., Lei, C., Zhou, Y., He, J., & Sun, Z. (2017) · Acta Diabetologica · doi:10.1007/s00592-016-0944-z · Cited by 37 · see citing works
- Authors
- Nguyen, T. T., Wang, J. J., & Wong, T. Y.
- Affiliations
- The University of Melbourne (AU)
- The University of Sydney (AU)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2007-10-01
- Volume
- 30
- Issue
- 10
- Pages
- 2708-2715
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2157241512
- Cited by
- 237
- References
- 129
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 11 · 2023: 11 · 2022: 13 · 2021: 10 · 2020: 16 · 2019: 13 · 2018: 8 · 2017: 14 · 2016: 16 · 2015: 13 · 2014: 19 · 2013: 6 · 2012: 14
- FWCI
- 1.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- National University of Singapore (submittedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Keywords
- retinal vascular changes, prediabetes, prehypertension, diabetic retinopathy, hypertensive retinopathy, retinal microvasculature, retinal vessel diameter, retinal tortuosity, microaneurysms, hyperglycemia, blood pressure, fundus photography
- MeSH terms
- Diabetic Retinopathy, Humans, Hypertension, Prediabetic State, Retinal Vessels
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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