Objective: To examine the association between apolipoprotein E (APOE) gene polymorphisms and retinal microvascular signs. Methods: Population-based, cross-sectional study. Participants from the Atherosclerosis Risk in Communities Study (n=10 036; aged 49-73 years) had retinal photographs taken in 1 randomly selected eye. Photographs were graded for presence of retinal microvascular signs using a standardized protocol; a computer-assisted method was used to measure retinal vessel diameter. DNA from blood samples was analyzed for common APOE alleles. Results: After adjusting for age, sex, systolic blood pressure, total serum cholesterol, triglycerides, and other covariates, APOE ε4 was associated with nondiabetic retinopathy in white (multivariate-adjusted odds ratio, 1.3;95% confidence interval, 1.0-1.6) and black (multivariate-adjusted odds ratio, 1.4; 95% confidence interval, 1.0-2.1) individuals. Other retinal microvascular signs were not strongly associated with APOE polymorphisms. Neither retinal arteriolar nor venular diameter was associated with APOE polymorphisms in white or black individuals. Conclusions: Apolipoprotein E ε4 was weakly associated with retinopathy in persons without diabetes. Other signs were less consistently associated with APOE polymorphisms.
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