Abstract

Background To cross‐sectionally and longitudinally examine whether retinal vessel traits are associated with glaucoma‐related outcomes (glaucoma, cup‐to‐disc ratio [CDR] and intraocular pressure [IOP]) and age‐related macular degeneration (AMD). Methods Baseline and 3‐year follow‐up data from the 30 097 participants of the Canadian Longitudinal Study on Aging were used. The follow‐up rate was 92%. QUARTZ, a deep learning algorithm, was used to extract data from retinal images including arteriolar and venular diameter, tortuosity and vertical CDR. Glaucoma and AMD were self‐reported. IOP was measured. Multiple linear and logistic regression were used to adjust for demographic, lifestyle and clinical factors. Results Having wider arterioles was associated with a lower odds of glaucoma (OR = 0.36, 95% CI: 0.20, 0.65) at baseline but there was no association using longitudinal data. Instead, glaucoma at baseline was strongly associated with 3‐year change in arteriolar diameter (β = −0.21, 95% CI: −0.37, −0.05) indicating that the cross‐sectional association may have been due to reverse causality. Using longitudinal data, greater venular tortuosity was associated with a reduced 3‐year development of glaucoma (OR = 0.52, 95% CI: 0.31, 0.87) and a 3‐year reduction in the CDR (β = −0.006, 95% CI: −0.010, −0.002). Wider venular diameter was associated with a higher odds of AMD at baseline (OR = 2.77, 95% CI: 1.50, 5.15) and a higher odds of the 3‐year development of AMD (OR = 4.15, 95% CI: 1.95, 8.82). Conclusions Understanding the temporal relationship of changes in the retinal microvasculature and the development of eye disease may lead to better treatment and prevention strategies.