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(Stroke. 2006;37:908.)
© 2006 American Heart Association, Inc.

Research Reports

Ten-Year Incidence of Retinal Emboli in an Older Population

From the Department of Ophthalmology, University of Sydney (Centre for Vision Research, Westmead Millennium Institute), and the Vision Cooperative Research Centre, Australia.

Reprint requests to Paul Mitchell, MD, PhD, Centre for Vision Research, Department of Ophthalmology, University of Sydney, Westmead Hospital, Hawkesbury Rd, Westmead, NSW Australia, 2145. E-mail paul_mitchell{at}wmi.usyd.edu.au

Background and Purpose— To assess 10-year incidence of retinal emboli and its predictors in an older population.

Methods— Survivors of 3654 Blue Mountains Eye Study participants 49 years of age were re-examined 5 and 10 years later. Incident emboli were assessed from retinal photographs.

Results— Cumulative 10-year incidence was 2.9% (95% CI, 2.1% to 3.6%) among 2361 at risk. Age was associated with incident emboli (P_trend=0.0001). After multivariate adjustment, hypertension (odds ratio [OR], 1.8; CI, 1.0 to 3.1), hypercholesterolemia (OR, 1.3; CI, 1.0 to 1.6), overweight (OR, 3.3; CI, 1.6 to 6.9), current smoking (OR, 2.5; CI, 1.1 to 5.9), increasing fibrinogen level (OR per mg/dL, 1.1; CI, 1.0 to 1.2), and retinal vascular signs (arteriovenous nicking OR, 2.0; CI, 1.2 to 3.6; arteriolar wall opacification OR, 2.3; CI, 1.1 to 5.0; retinal vein occlusion OR, 3.2; CI, 1.0 to 9.9) were significantly associated with incident emboli.

Conclusions— The 3% incidence of retinal arteriolar emboli found in this older population is likely to be an underestimate attributable to the transient nature of emboli and differential loss to follow-up. Most cardiovascular risk factors predict retinal embolism.

Key Words: cohort study • embolism • epidemiology • incidence

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