Retina disease linked to stroke in nondiabetics
New research suggests deterioration of the retina, or retinopathy, as determined with retinal photography, is an independent predictor of stroke or stroke-related death in older adults without diabetes.
“The blood vessels in the eyes share similar anatomic characteristics and other characteristics with the blood vessels in the brain,” lead author Dr. Paul Mitchell, from the University of Sydney in Australia, and colleagues note. “More research needs to be done to confirm these results, but it’s exciting to think that this fairly simple procedure could help us predict whether someone will be more likely to have a stroke several years later.”
The findings, which appear in the medical journal Neurology, are based on a study of 3,654 subjects, age 49 years or older, who had retinal photographs taken and then were followed-up for 7 years to assess cerebrovascular events.
During follow-up, 859 subjects died, including 97 from cerebrovascular causes, the investigators note. In addition, 24 cases of non-fatal stroke and 11 cases of transient ischemic attacks, or “mini-strokes,” were observed.
On further analysis, retinopathy was significantly linked to combined stroke events, raising the risk by 70 percent. This association was even stronger in subjects without severe high blood pressure or in those with at least two retinal microvascular signs; the presence of retinopathy in these groups nearly tripled the risk of cerebrovascular events.
“In this study, trained graders performed the retinal photographic assessment in a standardized setting,” the authors point out. “This assessment protocol needs to be translated to clinical practice using a more simplified grading system before a retinal assessment for stroke risk stratification could be considered to have practical clinical utility.”
SOURCE: Neurology, October 11, 2005.
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