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The Atherosclerosis Risk in Communities (ARIC) Study

Gerald Liew, MD, MPH; Anoop Shankar, MD, MPH; Jie Jin Wang, PhD; Ronald Klein, MD, MPH; Molly S. Bray, PhD; David J. Couper, PhD; A. Richey Sharrett, MD, DrPH; Tien Y. Wong, MD, MPH, PhD

Arch Ophthalmol. 2007;125(6):813-818.

Objective  To examine the association between apolipoprotein E (APOE) gene polymorphisms and retinal microvascular signs.

Methods  Population-based, cross-sectional study. Participants from the Atherosclerosis Risk in Communities Study (n = 10 036; aged 49-73 years) had retinal photographs taken in 1 randomly selected eye. Photographs were graded for presence of retinal microvascular signs using a standardized protocol; a computer-assisted method was used to measure retinal vessel diameter. DNA from blood samples was analyzed for common APOE alleles.

Results  After adjusting for age, sex, systolic blood pressure, total serum cholesterol, triglycerides, and other covariates, APOE 4 was associated with nondiabetic retinopathy in white (multivariate-adjusted odds ratio, 1.3; 95% confidence interval, 1.0-1.6) and black (multivariate-adjusted odds ratio, 1.4; 95% confidence interval, 1.0-2.1) individuals. Other retinal microvascular signs were not strongly associated with APOE polymorphisms. Neither retinal arteriolar nor venular diameter was associated with APOE polymorphisms in white or black individuals.

Conclusions  Apolipoprotein E 4 was weakly associated with retinopathy in persons without diabetes. Other signs were less consistently associated with APOE polymorphisms.

Author Affiliations: Centre for Vision Research, University of Sydney, Sydney, Australia (Drs Liew and Wang); Department of Community, Occupational, and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Drs Shankar and Wong); Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison (Dr Klein); Department of Pediatrics, Baylor College of Medicine, Houston, Tex (Dr Bray); Department of Biostatistics, University of North Carolina, Chapel Hill (Dr Couper); Department of Epidemiology, Johns Hopkins University, Baltimore, Md (Dr Sharrett); and Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia (Dr Wong).