Retinopathy-signs include microaneurysms, hemorrhages and soft exudates which are structural markers of microvascular damage from diabetes, hypertension and other processes.
Narrowed retinal arterioles predict for incidence of coronary artery disease in women.
Patients with retinopathy are twice as likely to develop congestive heart failure than those without this finding in a 7 year prospective study.
Risk of congestive heart failure higher in men, women, white and African Americans who have retinopathy.
In patients without diabetes, hypertension, or coronary artery disease the presence of retinopathy associated with a 3 fold increase in risk of CHF.
In type I diabetes each 10% decrease in HbA1c level reduces the risk of diabetic retinopathy by 39% and the benefits persist long after the period of intense control, associated demonstrated by DCCT.
UKPDS showed each 10% in HbA1c in diabetes type 2 reduces the risk of diabetic retinopathy by 25%.