Rheumatology International

, Volume 39, Issue 4, pp 669–677 | Cite as

Hand and knee osteoarthritis are associated with reduced diameters in retinal vessels: the AGES-Reykjavik study

  • Helgi JonssonEmail author
  • Diana E. Fisher
  • Gudny Eiriksdottir
  • Thor Aspelund
  • Ronald Klein
  • Vilmundur Gudnason
  • Mary Frances Cotch
Observational research


To investigate the association between osteoarthritis (OA) and microvascular pathology, we examined the relationship between retinal microvascular caliber and osteoarthritis of the hand and knee in an elderly population. The AGES-Reykjavik is a population-based, multidisciplinary longitudinal cohort study of aging. Retinal vessel caliber, hand osteoarthritis and total knee joint replacements due to OA were examined in 4757 individuals (mean age 76 ± 5 years; 57% female). Incident knee joint replacements during 5-year follow-up (n = 2961, mean age 75 ± 5 years; 58% female) were also assessed. Logistic regression analysis, adjusting for age, sex, and body mass index, showed an association between narrow arteriolar caliber and hand OA, as well as knee replacement. After adjustment for other covariates, including statin therapy, this association was significant for both hand OA in men and women [OR 1.10(1.03–1.17), p < 0.01] (per unit standard deviation decrease in CRAE) and TKR prevalence [OR 1.15 (1.01–1.32), p = 0.04], especially for men [OR 1.22 (1.00–1.51) p = 0.04] and also for incident TKRs in men [OR 1.50 (1.07–2.10), p = 0.04]. Narrow venular caliber was associated with hand OA in women [OR 1.10 (1.01–1.21), p = 0.03]. Retinal arterial narrowing in hand and knee OA is present in males as well as females. Venular narrowing in hand OA in women was an unexpected finding and is in contrast with the venular widening usually observed in cardiovascular diseases.


Osteoarthritis Retinal vessel diameters 


Author contributions

All authors have: (1) made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; (2) been involved in drafting the manuscript or revising it critically for important intellectual content; (3) given final approval of the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


This work was supported by the National Institutes of Health (Intramural Research Programs of the National Institute of Aging and the National Eye Institute, ZIAEY000401), National Institutes of Health contract number N01-AG-1-2100, the Icelandic Heart Association, and the Icelandic Parliament. The funders had no role in data collection, management, analysis and interpretation of the data, preparation, writing and approval of the manuscript, and decision to submit the manuscript for publication.

Compliance with ethical standards

Conflict of interest

The authors have no proprietary or commercial interest in any materials discussed in this article.

Ethical standards

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments. Both studies were approved by the Icelandic National Bioethics Committee, (VSN: 00-063, and VSN 09_098_S1) and the Data Protection Authority.

Ethical approval

Both studies were approved by the Icelandic National Bioethics Committee, (VSN: 00–063, and VSN 09_098_S1) and the Data Protection Authority.

Informed consent

All participants signed an informed consent declaration.

Consent to publish

The study is approved by the AGES-Reykjavik steering committee.

Data availability

All data are from the AGES-Reykjavik study and can be obtained upon application.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Landspitalinn University HospitalUniversity of IcelandReykjavikIceland
  2. 2.National Eye InstituteNational Institutes of Health (NIH)BethesdaUSA
  3. 3.Icelandic Heart AssociationKópavogurIceland
  4. 4.University of IcelandReykjavikIceland
  5. 5.Department of Ophthalmology and Visual SciencesUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA

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