Retinal microvascular abnormalities and MRI-defined subclinical cerebral infarction - The atherosclerosis risk in communities study

被引:169
作者
Cooper, LS
Wong, TY
Klein, R
Sharrett, AR
Bryan, RN
Hubbard, LD
Couper, DJ
Heiss, G
Sorlie, PD
机构
[1] Univ Melbourne, Ctr Eye Res Australia, Melbourne, Vic 3002, Australia
[2] NHLBI, NIH, Bethesda, MD 20892 USA
[3] Natl Univ Singapore, Eye Res Inst, Singapore 117548, Singapore
[4] Univ Wisconsin, Dept Ophthalmol, Madison, WI USA
[5] Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD USA
[6] Univ Penn, Div Radiol, Philadelphia, PA 19104 USA
[7] Univ N Carolina, Dept Biostat, Chapel Hill, NC USA
[8] Univ N Carolina, Dept Epidemiol, Chapel Hill, NC USA
关键词
cerebrovascular disorders; cerebral infarction; hypertension; retinal artery; retinal blood vessels; stroke;
D O I
10.1161/01.STR.0000195134.04355.e5
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose - Retinal microvascular abnormalities reflect cumulative small vessel damage from elevated blood pressure and may reflect subclinical cerebral microvascular changes. We examined their associations with MRI-defined cerebral infarcts. Methods - Population-based, cross-sectional study of 1684 persons 55 to 74 years of age without a history of clinical stroke, sampled from 2 US southeastern communities. Retinal photographs were obtained and graded for presence of retinal microvascular abnormalities, including arteriovenous nicking, focal arteriolar narrowing, retinal hemorrhages, soft exudates and microaneurysms. Photographs were also digitized, and retinal vessel diameters were measured and summarized as the arteriole-to-venule ratio (AVR). Cerebral MRI scans were graded for presence of cerebral infarct, defined as a lesion >= 3 mm diameter in a vascular distribution with typical imaging characteristics. Results - There were a total of 183 MRI cerebral infarcts. After adjustment for age, gender, race, 6-year mean arterial blood pressure, diabetes, and other stroke risk factors, cerebral infarcts were associated with retinal microvascular abnormalities, with odds ratios 1.90 (95% CI, 1.25 to 2.88) for arteriovenous nicking, 1.89 (95% CI, 1.22 to 2.92) for focal arteriolar narrowing, 2.95 (95% CI, 1.30 to 6.71) for blot hemorrhages, 2.08 (95% CI, 0.69, 6.31) for soft exudates, 3.17 (95% CI, 1.05 to 9.64) for microaneurysms, and 1.74 (95% CI, 0.95 to 3.21) for smallest compared with largest AVR. In stratified analyses, these associations were only present in persons with hypertension. Conclusions - Retinal microvascular abnormalities are associated with MRI-defined subclinical cerebral infarcts independent of stroke risk factors. These data suggest that retinal photography may be useful for studying subclinical cerebrovascular disease in population-based studies.
引用
收藏
页码:82 / 86
页数:5
相关论文
共 25 条
[1]  
AOKI N, 1975, JPN CIRC J
[2]   BRAIN MR - PATHOLOGIC CORRELATION WITH GROSS AND HISTOPATHOLOGY .1. LACUNAR INFARCTION AND VIRCHOW-ROBIN SPACES [J].
BRAFFMAN, BH ;
ZIMMERMAN, RA ;
TROJANOWSKI, JQ ;
GONATAS, NK ;
HICKEY, WF ;
SCHLAEPFER, WW .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1988, 151 (03) :551-558
[3]  
Bryan RN, 1999, AM J NEURORADIOL, V20, P1273
[4]   Infarctlike lesions in the brain: Prevalence and anatomic characteristics at MR imaging of the elderly - Data from the cardiovascular health study [J].
Bryan, RN ;
Wells, SW ;
Miller, TJ ;
Elster, AD ;
Jungreis, CA ;
Poirier, VC ;
Lind, BK ;
Manolio, TA .
RADIOLOGY, 1997, 202 (01) :47-54
[5]   Reliability of retinal photography in the assessment of retinal microvascular characteristics: The atherosclerosis risk in communities study [J].
Couper, DJ ;
Klein, R ;
Hubbard, LD ;
Wong, TY ;
Sorlie, PD ;
Cooper, LS ;
Brothers, RJ ;
Nieto, FJ .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 2002, 133 (01) :78-88
[6]   PATHOLOGICAL-STUDIES ON INTRACEREBRAL AND RETINAL ARTERIES IN CEREBROVASCULAR AND NONCEREBROVASCULAR DISEASES [J].
GOTO, I ;
KIMOTO, K ;
KATSUKI, S ;
MIMATSU, T ;
IKUI, H .
STROKE, 1975, 6 (03) :263-269
[7]   Cigarette smoking and other risk factors for silent cerebral infarction in the general population [J].
Howard, G ;
Wagenknecht, LE ;
Cai, JW ;
Cooper, L ;
Kraut, MA ;
Toole, JF .
STROKE, 1998, 29 (05) :913-917
[8]   Methods for evaluation of retinal microvascular abnormalities associated with hypertension/sclerosis in the atherosclerosis risk in communities study [J].
Hubbard, LD ;
Brothers, RJ ;
King, WN ;
Clegg, LX ;
Klein, R ;
Cooper, LS ;
Sharrett, AR ;
Davis, MD ;
Cai, JW .
OPHTHALMOLOGY, 1999, 106 (12) :2269-2280
[9]   Subcortical silent brain infarction as a risk factor for clinical stroke [J].
Kobayashi, S ;
Okada, K ;
Koide, H ;
Bokura, H ;
Yamaguchi, S .
STROKE, 1997, 28 (10) :1932-1939
[10]   Retinal arterial changes correlate with cerebral small-vessel disease [J].
Kwa, VIH ;
van der Sande, JJ ;
Stam, J ;
Tijmes, N ;
Vrooland, JL .
NEUROLOGY, 2002, 59 (10) :1536-1540