The Relationship of Retinal Vessel Caliber With Erectile Dysfunction in Patients With Type 2 Diabetes

PURPOSE. To investigate the relationship of retinal vessel caliber with erectile dysfunction (ED) in males with type 2 diabetes. METHODS. A hospital-based cross-sectional study. Male patients with type 2 diabetes were recruited from the Diabetic Management Project. All underwent a complete eye examination, a comprehensive interview, and blood and urine tests. Retinal vessel diameter was measured from retinal photographs by trained graders using semiautomated software. ED was defined as problems achieving or maintaining an erection and was assessed using a self-reported questionnaire. RESULTS. A total of 289 male patients with a mean (+/- SD) age of 65.3 years (+/- 11.2) were assessed. After adjusting for age, diastolic blood pressure, duration of diabetes, HbA(1c), total cholesterol, presence of diabetic retinopathy, and any diabetic complication, narrower retinal arteriolar diameter (odds ratio [OR] 1.66; 95% confidence interval [CI] 1.09-2.54; P = 0.019) and wider venular diameter (OR 1.58; 95% CI 1.03-2.44; P = 0.038) were associated with ED. CONCLUSIONS. Narrower retinal arteriolar and wider venular diameter are independently associated with an increased risk of self-reported ED. These results suggest a microvascular component in the pathogenesis of this condition.