Relationship between HbA1c and risk of retinal hemorrhage in the Japanese general population: The Circulatory Risk in Communities Study (CIRCS).

AIMS: Retinal hemorrhage is an important finding on fundus photography. Diabetes mellitus is a cause of retinal hemorrhage, although other causes exist. We sought to better characterize the association between retinal hemorrhage and HbA1c in the Japanese population.

METHODS

We conducted a prospective study of 11,644 Japanese men and women aged 30-78years between 2001 and 2011. Fundus photography was performed as part of an annual cardiovascular disease risk survey. HbA1c was determined by the latex coagulation method throughout the study. We used logistic regression models to examine the association between HbA1c and the risk of retinal hemorrhage and diabetic retinal hemorrhage.

RESULTS

During a median follow-up period of 4.6years, 509 retinal hemorrhages, including 96 diabetic retinal hemorrhages, were diagnosed. HbA1c was positively associated with the risk of retinal hemorrhage and diabetic retinal hemorrhage among subjects not taking medication for diabetes mellitus at baseline, but not among subjects who were taking medication at baseline.

CONCLUSIONS

HbA1c was positively associated with the risk of retinal hemorrhage and the subcategory of diabetic retinal hemorrhage among subjects not taking medication for diabetes mellitus at baseline. The association was evident for diabetic retinal hemorrhage, compared with retinal hemorrhage.