Retinal Vascular Obstruction and Asymptomatic Cerebral Infarction

Ueda, Yoshiko; Kanazawa, Suketaka; Ohira, Akihiro; Miyamura, Noritake; Takaki, Tadahiro; Kitaoka, Takashi; Amemiya, Tsugio

doi:10.1016/s0021-5155(01)00500-7

Cited by 20 publications

(14 citation statements)

References 15 publications

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“…Among the 62 975 subjects, 1900 had a clinically evident stroke (total of incident and prevalent stroke), and 993 had infarction seen on brain imaging with no stated clinical correlate. We were unable to extract the number of strokes from 6/37 papers 19 23 25 36 38 39. The number of strokes per paper varied from eight to 496 10 32…”

Section: Resultsmentioning

confidence: 99%

“…Thirty of the 37 papers defined “stroke” in the index paper or related publications 8 – 16 18 – 24 26 – 30 32 – 40. Nine of the 37 papers used asymptomatic infarcts seen on brain imaging 9 10 27 29 – 31 36 – 38. The other 28 papers assessed some measure of clinical stroke of which only 9/28 papers subtyped stroke into haemorrhagic or ischaemic 8 14 15 23 26 32 – 34 40.…”

Section: Resultsmentioning

confidence: 99%

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Retinal microvascular abnormalities and stroke: a systematic review

Doubal

Hokke

Wardlaw

2009

Journal of Neurology, Neurosurgery & Psychiatry

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Background: Lacunar strokes account for 25% of ischaemic strokes, but their precise aetiology is unknown. Similarities between the retinal and cerebral small vessels mean that clarification of the exact relationship between retinal microvascular abnormalities and stroke, and particularly with stroke subtypes, may aid understanding of the aetiology of lacunar stroke and stroke risk. Methods: A systematic review of the literature was performed by searching Medline and Embase to October 2007 for studies in humans that investigated the association between retinal microvascular abnormalities and prevalent or incident stroke. Data and calculated summary risk ratios (sRR) were extracted for associations between retinal microvascular abnormalities and stroke, including stroke subtypes where possible, adjusted for key variables. 37 papers from 22 different studies were included with 62 975 subjects (mean age 62 years) among whom there were 2893 strokes. Stroke identification and diagnosis methods varied. Results: Retinopathy was associated with incident stroke (sRR 2.1, 95% CI 1.7 to 2.6) and prevalent stroke (sRR 2.5, 95% CI 1.4 to 4.3). Incident stroke was also associated with retinal artery embolism (sRR 2.9, 95% CI 1.6 to 5.1) and venular widening (sRR 1.4, 95% CI 1.1 to 1.7). There was significant heterogeneity between studies for some associations. There were no data on retinal microvascular abnormalities and haemorrhagic versus ischaemic stroke or ischaemic stroke subtypes. Conclusions: Retinal microvascular abnormalities are associated with stroke, but more data are required to clarify associations between specific types of retinal microvascular abnormality and stroke, as well as between different stroke subtypes. Future retinal-stroke studies should concentrate on carefully diagnosing and accurately sub-typing ischaemic stroke.Lacunar ischaemic stroke accounts for 25% of all ischaemic strokes, 1 but its precise aetiology is unknown.2 Possible causes include atherothromboembolism, 3 intracranial large artery stenosis, intrinsic microvascular atheroma, or endothelial dysfunction manifesting either through ischaemia or failure of the blood-brain barrier. 4 The cerebral blood vessels that, when diseased, give rise to lacunar stroke share many characteristics with retinal vessels, 5 being developmentally related during embryogenesis and of similar diameter (50-250 mm). Retinal vessels are visibly affected by known risk factors for stroke such as diabetes and hypertension.6 Therefore, determining any association between retinal microvascular abnormalities and stroke may improve understanding of the nature of the cerebral small vessel changes underlying lacunar ischaemic stroke and aid cerebrovascular and cardiovascular risk profiling.Several studies have examined a possible link between stroke and the retina, including large epidemiological studies in community-dwelling populations and small detailed studies of patients with specific diseases attending tertiary hospitals. The presence and strength of any repo...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Retinal microvascular abnormalities and stroke: a systematic review

Doubal

Hokke

Wardlaw

2009

Journal of Neurology, Neurosurgery & Psychiatry

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“…It is suggested that an increase in PWV in the controls is reversible, depending on the blood pressure, while that in BRVO patients may not be reversed by lowering the blood pressure and can have a greater impact in terms of the risk of cardiovascular diseases. Ueda et al [25] reported that asymptomatic cerebral infarction appeared more frequently in patients with retinal vascular obstruction than in normal adults. Because the PWV measurement is a very simple procedure and takes only 5 min, it should be proposed that patients with BRVO are screened for their risk of cardiovascular diseases on the basis of the PWV.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Arterial Stiffness in Patients with Branch Retinal Vein Occlusion

Nakazato

Watanabe²,

Kawana

et al. 2005

Ophthalmologica

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Purpose: To assess the arterial stiffness in patients with branch retinal vein occlusion (BRVO). Methods: Brachial-ankle pulse wave velocity (PWV) and ankle-brachial index were measured in 10 patients with BRVO (mean age 67.9 ± 7.5 years) and in 18 age-matched controls (mean age 66.9 ± 6.8 years). The controls were subjects with systemic essential hypertension having no retinal lesions. Results: The PWV in the BRVO group was 1,946 ± 254 cm/s which was significantly higher than that in the control group (1,688 ± 274 cm/s; p = 0.014, Wilcoxon rank sum test). The ankle-brachial indexes were 1.16 and 1.15 in BRVO and control groups, respectively. There was no significant difference between the groups (p = 0.944). In the control group, there was a significant positive correlation between PWV and systolic blood pressure (Spearman correlation coefficient r_s = 0.385, p = 0.043), while no significant correlation was found in the BRVO group (Spearman correlation coefficient r_s = –0.188, p = 0.603). Conclusion: The arterial stiffness is increased in patients with BRVO which was thought to be due to the structural changes of the artery and not dependent on the blood pressure.

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“…4 Recent studies suggest that RAO is associated with stroke and mortality caused by stroke. [5][6][7][8][9][10][11][12][13][14][15] In the present study, we therefore investigated the possible association between RAO and the subsequent risk of stroke occurrence based on RAO cases and their controls obtained from a nationwide representative sampling of 1 025 340 adults. comprised 1 025 340 nationally representative random subjects, amounting to ≈2.2% of the entire population in the Korean National Health Insurance Service in 2002.…”

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confidence: 99%

Retinal Artery Occlusion and the Risk of Stroke Development

Rim

Han

Choi

et al. 2016

Stroke

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Background and Purpose— Our aim was to evaluate the risk of subsequent stroke development after retinal artery occlusion (RAO). Methods— National registry data were collected from the Korean National Health Insurance Service, comprised 1 025 340 random subjects. Patients diagnosed with RAO in 2002 and 2003 were excluded. The RAO group was composed of patients with an initial diagnosis of either central or other RAO between January 2004 and December 2013 (n=401). The comparison group was composed of randomly selected patients (5 per RAO patient; n=2003) who were matched to the RAO group according to sociodemographic factors and year of RAO diagnosis. Each sampled patient was tracked until 2013. Cox proportional hazard regression was used. Results— Stroke occurred in 15.0% of the RAO group and in 8.0% of the comparison group ( P < 0.001). RAO was associated with an increased risk of stroke occurrence (hazard ratio, 1.78; 95% confidence interval, 1.32–2.41). The magnitude of the RAO effect for stroke was larger among younger adults aged <65 years (hazard ratio, 3.11) than older adults aged ≥65 years (hazard ratio, 1.26). However, the risk of subsequent stroke was significantly increased in older adults aged ≥65 years at the 4-year follow-up (hazard ratio, 1.58; 95% confidence interval, 1.01–2.48). Conclusions— RAO was significantly associated with subsequent stroke after adjusting for comorbidities and sociodemographic factors. These findings are limited by uncontrolled confounding factors and need to be replicated by other observational studies.

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Retinal Vascular Obstruction and Asymptomatic Cerebral Infarction

Cited by 20 publications

References 15 publications

Retinal microvascular abnormalities and stroke: a systematic review

Retinal microvascular abnormalities and stroke: a systematic review

Evaluation of Arterial Stiffness in Patients with Branch Retinal Vein Occlusion

Retinal Artery Occlusion and the Risk of Stroke Development

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