Prevalence of Retinal Vascular Anomalies in the German Population: Results from the Gutenberg Health Study

To determine the prevalence of retinal vascular anomalies in the general population in Germany and to analyse potential associations with ocular and systemic factors. The Gutenberg Health Study is a population-based cohort study, including 15,010 participants aged 35–74 years. We performed fundus photographs of the macula and the optic disc. Vascular anomalies of the retina were graded. The prevalence was computed. We conducted multivariable logistic regression analysis including generalized estimating equations to assess associated factors. We included 12,956 participants (mean age 55.0 ± 11.1 years; 49.8% female). Retinal arterial tortuosity (RAT) was present in 5.9% in at least one eye and in 3.7% in both eyes. Systolic (OR = 1.01, <i>p</i> = 0.0039) and diastolic (OR = 0.98, <i>p</i> = 0.0039) arterial blood pressure, low-density lipoproteins (LDL) levels (OR = 1.0, <i>p</i> = 0.036), and spherical equivalent (OR = 1.06, <i>p</i> &lt; 0.0001) were associated with RAT. Birth weight (OR = 0.97, <i>p</i> &lt; 0.0001) and age (OR = 0.85, <i>p</i> = 0.0004) were inversely associated, while high-density lipoproteins (HDL), body mass index, and smoking were not associated with RAT. Temporal cilioretinal arteries (CRA) were prevalent in at least one eye in 40.2% and in 9.2% in both eyes. Spherical equivalent was associated with the prevalence of CRA (OR = 1.03 per dpt, p = 0.0006). Branch-building CRA had a prevalence of 0.5% in at least one eye. This study describes prevalence of retinal vascular anomalies for the first time in a German population. CRA were positively associated with spherical equivalent and thus might be protective for myopia. RAT was associated with cardiovascular risk factors and with lower birth weight.