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Are Microvascular Abnormalities in the Retina Associated With Depression Symptoms? The Cardiovascular Health Study

From the Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia (CS, GT, TYW); the Department of Ophthalmology and Vision Sciences, University of Wisconsin, Madison, WI (RK, BEKK); the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC (DCS); the Departments of Biostatistics (EKML) and Medicine and Epidemiology (DSS), University of Washington, Seattle, WA; and the Singapore Eye Research Institute, National University of Singapore, Singapore (TYW).

Objective: Depression has been linked with vascular risk factors and stroke. The authors examined the relationship between retinal microvascular abnormalities and depression symptoms in an elderly population.

Methods: The Cardiovascular Health Study is a population-based study conducted in four U.S. communities initiated in 1989–1990. A total of 2,420 persons aged 65 years and older were included in the current analyses. During the 1997–1998 examination, retinal photographs were performed and assessed for retinal microvascular abnormalities (retinopathy, focal arteriolar narrowing, arteriovenous nicking, generalized retinal arteriolar narrowing, and generalized retinal venular dilation) according to standardized methods. Depression symptoms were assessed by a modified version of the Centers for Epidemiologic Studies Depression (CES-D) scale annually from 1989 through 1997–1998 and was defined as a CES-D score of >9.

Results: Participants with retinal microvascular abnormalities were not more likely to have depression symptoms, with adjusted odds ratio (OR) (95% confidence intervals) of 1.08 (0.71–1.65) for retinopathy, OR 1.09 (0.71–1.68) for focal arteriolar narrowing, OR 0.85 (0.52–1.40) for arteriovenous nicking, OR 0.97 (0.70–1.34) for generalized arteriolar narrowing, and OR 0.79 (0.56–1.12) for generalized venular dilation. Retinal microvascular abnormalities were not related to depression symptoms in multinomial logistic regression comparing the three top quartiles of the depression CES-D scores with the lowest quartile.

Conclusions: Our study did not find an association between retinal microvascular abnormalities and depression symptoms in older people.

Key Words: Retinal microvascular abnormalities • retinal arteriolar narrowing • retinopathy • focal narrowing • arteriovenous nicking • depression symptoms