Cheung, Ning and Mosley, Thomas and Islam, Amirul and Kawasaki, Ryo and Sharrett, A. Richey and Klein, Ronald and Coker, Laura H. and Knopman, David S. and Shibata, Dean K. and Catellier, Diane and Wong, Tien Y. (2010) Retinal microvascular abnormalities and subclinical magnetic resonance imaging brain infarct: a prospective study. Brain: a Journal of Neurology , 133 (7). pp. 1987-1993. ISSN 0006-8950
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Identification Number or DOI: doi: 10.1093/brain/awq127
Silent brain infarct and white matter lesions are common radiological findings associated with the risk of clinical stroke and dementia; however, our understanding of their underlying pathophysiology and risk factors remains limited. This study aimed to determine whether assessment of retinal microvascular abnormalities could provide prognostic information regarding the risk of brain infarct and white matter lesions on magnetic resonance imaging. This study is based on a subset of 810 middle-aged persons without clinical stroke or baseline magnetic resonance imaging infarct enrolled in the Atherosclerosis Risk in Communities Brain Magnetic Resonance Imaging Study, a prospective, population-based study. Participants had a baseline magnetic resonance imaging brain examination and retinal photography in 1993–1995, and returned for a repeat magnetic resonance imaging examination in 2004–2006. Magnetic resonance images were graded for presence of any cerebral infarct, infarct with lacunar characteristics and white matter lesions according to standardized protocols. Retinal photographs were graded for presence of retinopathy lesions and retinal arteriolar abnormalities following a standardized protocol. Over a median follow-up of 10.5 years, 164 (20.2%) participants developed cerebral infarct, 131 (16.2%) developed lacunar infarct, 182 (24.2%) developed new white matter lesions and 49 (6.1%) had evidence of white matter lesion progression. After adjusting for age, gender, race, cardiovascular risk factors and carotid intima-media thickness, retinopathy was associated with incident cerebral infarct (odds ratio 2.82; 95% confidence interval 1.42–5.60) and lacunar infarct (odds ratio 3.19; 95% confidence interval: 1.56–6.50). Retinal arteriovenous nicking was associated with incident cerebral infarct (odds ratio 2.82; 95% confidence interval: 1.66–4.76), lacunar infarct (odds ratio 2.48; 95% confidence interval: 1.39–4.40) and white matter lesion incidence (odds ratio 2.12; 95% confidence interval: 1.18–3.81) and progression (odds ratio 2.22; 95% confidence interval:1.00–5.88). In conclusion, retinal microvascular abnormalities are associated with emergence of subclinical magnetic resonance imaging brain infarcts and white matter lesions, independent of shared risk factors. Retinal vascular imaging may offer a non-invasive tool to investigate the pathogenesis and natural history of cerebral small-vessel disease.
|Item Type:||Article (Commonwealth Reporting Category C)|
|Additional Information:||Copyright: The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: email@example.com|
|Uncontrolled Keywords:||cerebral infarction; cerebral ischaemia; epidemiology; retina; stroke|
|Fields of Research (FOR2008):||11 Medical and Health Sciences > 1109 Neurosciences > 110904 Neurology and Neuromuscular Diseases|
11 Medical and Health Sciences > 1103 Clinical Sciences > 110320 Radiology and Organ Imaging
11 Medical and Health Sciences > 1116 Medical Physiology > 111603 Systems Physiology
|Socio-Economic Objective (SEO2008):||E Expanding Knowledge > 97 Expanding Knowledge > 970111 Expanding Knowledge in the Medical and Health Sciences|
|Deposited On:||13 Jan 2012 14:35|
|Last Modified:||17 Feb 2012 13:40|
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