Centre for Medical and Health Sciences Education

The proposed study will measure and characterize early retinal vessel changes in persons with diabetes and persons at high risk of diabetes (impaired fasting glucose [IFG], impaired glucose tolerance [IGT], and the metabolic syndrome) in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), a population-based study of risk factors and complications of diabetes. Specifi c Aims of the study are: 1. To determine the relationship of retinal vessel diameter changes (generalized arteriolar narrowing, venular dilation, focal arteriolar narrowing, and arterio-venous nicking) to prevalent diabetes and glucose intolerance (IFG and IGT); 2. To examine the relationship of retinal vessel diameter changes to the metabolic syndrome (obesity, dyslipidaemia, hypertension and insulin resistance); 3. To quantify the relationship of retinal vessel diameter changes to macrovascular (cardiovascular disease [CVD], peripheral arterial disease [PVD]) and microvascular (nephropathy, neuropathy) complications in persons with diabetes, glucose intolerance; and 4. To determine if retinal vessel diameter changes predict the 5-year incidence of overt diabetes, independent of known risk factors (e.g., glucose tolerance, obesity). In the proposed study, we will measure retinal vessel diameters and other changes from the digital retinal photographs taken of a sample (n=2,177) of the AusDiab population. This will include a (1) new computer-based quantitative measurement of retinal vessel diameter, and a (2) qualitative assessment of the presence of discrete retinal arteriolar wall signs (focal arteriolar narrowing, arteriolar wall opacifi cation, and AV nicking). We will then examine the relationship of these retinal vessel changes to diabetes and pre-diabetes status, to the metabolic syndrome, and to various diabetic complications. Finally, we will determine if these retinal vessel changes at baseline are related prospectively to the 5-year incidence of overt diabetes among participants who return for the follow-up AusDiab examination. 2. The Epidemiology, Causes and Patterns of CNV Supervisors Mr Robert West Investigators: A/ Prof Tien Wong Location: Dept of Surgery, Alfred Hospital