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Published Online
on February 28, 2008

Stroke. 2008
Published online before print February 28, 2008, doi: 10.1161/STROKEAHA.107.495648
A more recent version of this article appeared on April 1, 2008
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*Retinal Disorders
*Stroke
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Submitted on June 6, 2007
Revised on August 1, 2007
Accepted on September 19, 2007

Is Routine Retinal Examination Useful in Patients With Acute Ischemic Stroke?

Deidre A. De Silva MRCP; Tien Y. Wong FRANZCO, PhD*; Hui-Meng Chang MRCP; Bee-Fang Ng BSc; Gabriella Tikellis PhD; Seang Mei Saw PhD; Fung-Peng Woon MSc; Christopher P.L.H. Chen FRCP; and Meng-Cheong Wong FRCP

From the Singapore General Hospital Campus (D.A.D., H.M.C., M.C.W.), National Neuroscience Institute, Singapore; the Centre for Eye Research Australia (T.Y.W., G.T.), University of Melbourne, Melbourne, Australia; the Singapore Eye Research Institute (T.Y.W., B.F.N.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; the Department of Community Occupational and Family Medicine (S.M.S.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; the National Heart Centre (F.P.W.), Singapore; and the National Medical Research Council (C.P.L.H.C.), Singapore.

* To whom correspondence should be addressed. E-mail: twong{at}unimelb.edu.au.

Background and Purpose—Patients with ischemic stroke have a high prevalence of hypertension and diabetes, which are major risk factors for potentially blinding retinal diseases. We studied the prevalence of retinal diseases, and the need for an ophthalmology referral, among persons with acute ischemic stroke.

Methods—We conducted a prospective study of 300 consecutive patients with acute ischemic stroke. Retinal photographs were taken and assessed in a masked fashion. Patients were advised and referred if they required an ophthalmology evaluation.

Results—Of the 286 patients with gradable photographs, retinal abnormalities were detected in 59%. Ophthalmology evaluation was advised for 3% of patients on an urgent basis and 28% on a nonurgent basis and resulted in either acute treatment or active follow-up for all who were subsequently reviewed.

Conclusions—Patients with acute ischemic stroke have a high prevalence of retinal abnormalities. This study suggests that a routine retinal examination may provide an opportunity to detect potentially vision-threatening retinal diseases.


Key words: diabetes • retinal • ischemic • retinopathy • stroke