on February 28, 2008
Published online before print February 28, 2008, doi: 10.1161/STROKEAHA.107.496091
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Submitted on June 11, 2007
From the Centre for Eye Research Australia (M.L.B., J.J.W., T.Y.W.), University of Melbourne, Victoria, Australia; the Department of Neurology (M.L.B., P.J.H.), Royal Melbourne Hospital, Victoria, Australia; the Centre for Vision Research (J.J.W.), University of Sydney, Sydney, Australia; and the Singapore Eye Research Institute (T.Y.W.), National University of Singapore, Singapore. * To whom correspondence should be addressed. E-mail: twong{at}unimelb.edu.au.
Background and Purpose—The retinal and cerebral vasculature share similar anatomic, physiological, and embryological characteristics. We reviewed the literature, focusing particularly on recent population-based studies, to examine the relationship between retinal signs and stroke. Summary of Review—Hypertensive retinopathy signs (eg, focal retinal arteriolar narrowing, arterio-venous nicking) were associated with prevalent stroke, incident stroke, and stroke mortality, independent of blood pressure and other cerebrovascular risk factors. Diabetic retinopathy signs (eg, microaneurysms, hard exudates) were similarly associated with incident stroke and stroke mortality. Retinal arteriolar emboli were associated with stroke mortality but not incident stroke. There were fewer studies on the association of other retinal signs such as retinal vein occlusion and age-related macular degeneration with stroke, and the results were less consistent. Conclusion—Many retinal conditions are associated with stroke, reflecting possible concomitant pathophysiological processes affecting both the eye and the brain. However, the incremental value of a retinal examination for prediction of future stroke risk remains to be determined.
Revised on August 4, 2007
Accepted on September 13, 2007
Retinal Signs and Stroke. Revisiting the Link Between the Eye and Brain
Michelle L. Baker MD;
Key words: stroke • mortality • hypertensive retinopathy • diabetic retinopathy • population-based cohort