Retinal Microvascular Changes and Risk of Stroke

Cheung, Carol Y.; Tay, Wan Ting; Ikram, M. Kamran; Ong, Yi Ting; Silva, Deidre Anne De; Chow, Khuan Yew; Wong, Tien Yin

doi:10.1161/strokeaha.113.001738

Cited by 124 publications

(108 citation statements)

References 39 publications

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“…The Singapore Malay Eye Study (SMES) also reported as association between baseline retinopathy and incident stroke during 4 years of follow up and developed models that improved upon those based on vascular risk factors by incorporating retinal vascular parameters. (5) These models improved classification of stroke outcome by 10%.…”

Section: Relationship Between Chronic Retinal Microvascular Disease Amentioning

confidence: 95%

“…En face images also permit analysis of vessel tortuosity,(4) fractal dimension and branching angles. (5) Focal thinning of retinal layers, as can be measured with OCT, may be a marker of prior vascular events causing ischemia. These analysis methods require high quality images and specialized analysis capabilities, which may not be available in the clinical setting.…”

Section: Methods Of Retinal Vessel Analysismentioning

confidence: 99%

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Retinal Vascular Changes are a Marker for Cerebral Vascular Diseases

Moss

2015

Curr Neurol Neurosci Rep

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The retinal circulation is a potential marker of cerebral vascular disease because it shares origin and drainage with the intracranial circulation and because it can be directly visualized using ophthalmoscopy. Cross sectional and cohort studies have demonstrated associations between chronic retinal and cerebral vascular disease, acute retinal and cerebral vascular disease and chronic retinal vascular disease and acute cerebral vascular disease. In particular, certain qualitative features of retinopathy, retinal artery occlusion and increased retinal vein caliber are associated with concurrent and future cerebrovascular events. These associations persist after accounting for confounding variables known to be disease-causing in both circulations, which supports the potential use of retinal vasculature findings to stratify individuals with regards to cerebral vascular disease risk.

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Section: Relationship Between Chronic Retinal Microvascular Disease Amentioning

confidence: 95%

Section: Methods Of Retinal Vessel Analysismentioning

confidence: 99%

Retinal Vascular Changes are a Marker for Cerebral Vascular Diseases

Moss

2015

Curr Neurol Neurosci Rep

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“…Changes in retinal vascular calibre may also represent an individualised indicator of how well diabetes is controlled [100]. Recent studies in the general population have demonstrated that the addition of retinal vascular imaging to existing models of stroke can improve risk stratification [101,102]. However, the overall improvement is only about 10% beyond that of established risk factors.…”

Section: Retinal Vasculature Measurements In Clinical Practicementioning

confidence: 99%

The clinical implications of recent studies on the structure and function of the retinal microvasculature in diabetes

et al. 2015

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The retinal blood vessels provide the opportunity to study early structural and functional changes in the microvasculature prior to clinically significant microvascular and macrovascular complications of diabetes. Advances in digital retinal photography and computerised assessment of the retinal vasculature have provided more objective and precise measurements of retinal vascular changes. Clinic-and population-based studies have reported that these quantitatively measured retinal vascular changes (e.g. retinal arteriolar narrowing and venular widening) are associated with preclinical structural changes in other microvascular systems (e.g. infarct in the cerebral microcirculation), as well as diabetes and diabetic complications, suggesting that they are markers of early microvascular dysfunction. In addition, there are new retinal imaging techniques to further assess alterations in retinal vascular function (e.g. flicker-induced vasodilatory response, blood flow and oxygen saturation) in diabetes and complications that result from the effects of chronic hyperglycaemia, inflammation and endothelial dysfunction.In this review, we summarise the latest findings on the relationships between quantitatively measured structural and functional retinal vascular changes with diabetes and diabetic complications. We also discuss clinical implications and future research to evaluate whether detection of retinal vascular changes has additional value beyond that achieved with methods currently used to stratify the risk of diabetes and its complications.

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“…We have previously used the database for other studies. 21,22 MI was defined as either (1) definitive or clinical MI; or (2) death cases signed up by pathologists or physicians as MI, with or without necropsy done. Incident MI was identified by linkage with a subset of the National Registry of Diseases Office database: the Singapore Myocardial Infarction Registry, which captures all MI diagnosed and coded with International Classification of Diseases 9th Revision (ICD-9) 410 in all hospitals.…”

Section: This Ismentioning

confidence: 99%