Multi-Ethnic Study of Atherosclerosis (MESA) - Ancillary Eye Study
Condition: Atherosclerosis; Cardiovascular Diseases; Coronary Arteriosclerosis; Coronary Disease; Cerebrovascular Disorders; Heart Failure, Congestive; Myocardial Infarction; Heart Diseases; Diabetes Mellitus, Non-insulin Dependent; Hypertension; Diabetic Retinopathy; Macular Degeneration; Diabetes Mellitus
MeSH terms: Cerebrovascular Disorders; Macular Degeneration; Diabetic Retinopathy; Heart Failure; Cardiovascular Diseases; Myocardial Infarction; Atherosclerosis; Coronary Disease; Coronary Artery Disease; Arteriosclerosis; Myocardial Ischemia; Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Observational

Summary: 
      To evaluate the relation of retinal microvascular characteristics to subclinical
      cardiovascular disease, clinical disease, and their risk factors in the Multi-Ethnic Study of
      Atherosclerosis (MESA) cohort.
    

Detailed description: 
      BACKGROUND:

      The study further expands and enlarges the findings of the NHLBI-supported Atherosclerosis
      Risk in Communities (ARIC) study on the relationship of retinal microvascular disease to the
      presence of subclinical and clinical cardiovascular disease among Multi-Ethnic Study of
      Atherosclerosis (MESA) participants. ARIC data showed that retinal microvascular changes were
      associated with the following findings: markers of persistent hypertensive damage, markers of
      inflammation and endothelial dysfunction, magnetic resonance imaging (MRI)-detected cerebral
      infarct independent of hypertension, predictive of 3-year incident stroke independent of
      hypertension, and predictive of 3-year incident coronary heart disease in women but not men.

      DESIGN NARRATIVE:

      The MESA-EYE study is a separate add-on to the Multi-Ethnic Study of Atherosclerosis, a six
      regional center 10 year program begun in July 2000. The overall goals of the parent study are
      the identification of risk factors for subclinical cardiovascular disease, for progression of
      subclinical disease, and for transition of subclinical to clinical cardiovascular disease.
      The eye component will tie in with Exam 2 of the main study which begins August 2002 and runs
      through January 2004. Retinal photography to document microvascular changes will be performed
      on the approximately 6,500 MESA participants at Exam 2. Retinal photography will follow a
      standardized written protocol similar to that used in ARIC. Focal arterial narrowing and AV
      nicking will be classified as definite, questionable, or none. Data handling will be based on
      protocols previously used in several other NIH sponsored clinical trials where eye retinal
      studies were performed.

      The six specific aims of the study are to: (1) determine the relationship of retinal
      microvascular characteristics to measures of subclinical CVD through (a) magnetic resonance
      imaging of left ventricular function (b) brachial artery ultrasound for flow mediated
      endothelial vasodilatation (c) radial artery tonometry measurement of peripheral artery
      function (d) magnetic resonance imaging for myocardial perfusion; (2) determine relationship
      of retinal microvascular characteristics to clinical CVD, specifically: (a) coronary heart
      disease (b) congestive cardiac failure (c) stroke; (3) determine relationship of retinal
      microvascular characteristics to CVD risk factors, specifically:(a) development of type 2
      diabetes (b) development of hypertension (c) markers of: (I) inflammation (II) hemostasis
      (III) fibrinolysis; (4) determine the relation of retinal microvascular changes to structural
      and functional disorders of the brain; (5) describe the prevalence of retinal microvascular
      abnormalities in different racial/ethnic groups; (6) describe the prevalence and risk factors
      of (a) diabetic retinopathy (b) age-related maculopathy.
    

Observational model: Cohort
Time perspective: Prospective