מתוך medicontext.co.il
LONDON (Reuters Health) – Individuals with microvascular abnormalities on retinal photographs are more likely to experience a stroke than people without such abnormalities, according to a report published in the October 6th issue of The Lancet.
Previous findings have suggested that retinal vascular abnormalities may reflect cerebral vascular disease, but epidemiologic studies have yielded conflicting results. In the belief that the inconsistency may have arisen partly from reliance on ophthalmoscopy, Dr. Tien Yin Wong, from the University of Wisconsin at Madison, and colleagues assessed the incident stroke rate of 10,358 middle-aged people who underwent retinal photography.
Over a mean followup period of 3.5 years, 110 subjects experienced incident strokes, the investigators state. After controlling for patient demographics, blood pressure, diabetes, and other stroke risk factors, the investigators identified several retinal microvascular abnormalities that conferred an increased stroke risk.
The relative risk of experiencing an incident stroke was 2.58 for any retinopathy, 3.11 for microaneurysms, 3.08 for soft exudates, 2.55 for blot haemorrhages, 2.26 for flame-shaped haemorrhages, and 1.60 for arteriovenous nicking, the authors report. In addition, a decreased arteriole-to-venule ratio was associated with an increased stroke risk.
Similar risk patterns were found when only ischemic strokes were considered, and the risk patterns were similar for hypertensive individuals with or without diabetes.
"The retinal arterioles offer a unique opportunity to investigate the role of the microcirculation in cerebrovascular diseases, because they are accessible to direct non-invasive assessment, and they share anatomical and physiological characteristics with the cerebral arterioles," the investigators explain.
The current findings suggest that "retinal photography may be useful for cerebrovascular risk stratification in appropriate populations," Dr. Wong's team concludes.
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