Retinal microvascular abnormalities and subclinical magnetic resonance imaging brain infarct: a prospective study

Article


Cheung, Ning, Mosley, Thomas, Islam, Amirul, Kawasaki, Ryo, Sharrett, A. Richey, Klein, Ronald, Coker, Laura H., Knopman, David S., Shibata, Dean K., Catellier, Diane and Wong, Tien Y.. 2010. "Retinal microvascular abnormalities and subclinical magnetic resonance imaging brain infarct: a prospective study ." Brain. 133 (7), pp. 1987-1993. https://doi.org/10.1093/brain/awq127
Article Title

Retinal microvascular abnormalities and subclinical magnetic resonance imaging brain infarct: a prospective study

ERA Journal ID14495
Article CategoryArticle
AuthorsCheung, Ning (Author), Mosley, Thomas (Author), Islam, Amirul (Author), Kawasaki, Ryo (Author), Sharrett, A. Richey (Author), Klein, Ronald (Author), Coker, Laura H. (Author), Knopman, David S. (Author), Shibata, Dean K. (Author), Catellier, Diane (Author) and Wong, Tien Y. (Author)
Journal TitleBrain
Brain: a journal of neurology
Journal Citation133 (7), pp. 1987-1993
Number of Pages7
Year2010
Place of PublicationOxford, United Kingdom
ISSN0006-8950
1460-2156
Digital Object Identifier (DOI)https://doi.org/10.1093/brain/awq127
Web Address (URL)http://brain.oxfordjournals.org/content/133/7/1987.full.pdf+html
Abstract

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.

Keywordscerebral infarction; cerebral ischaemia; epidemiology; retina; stroke
ANZSRC Field of Research 2020320905. Neurology and neuromuscular diseases
320222. Radiology and organ imaging
320803. Systems physiology
Public Notes

Copyright: The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Byline AffiliationsUniversity of Melbourne
University of Mississippi Medical Center, United States
Department of Mathematics and Computing
Johns Hopkins University, United States
University of Wisconsin-Madison, United States
Wake Forest University, United States
Mayo Clinic, United States
University of Washington Medical Centre, United States
University of North Carolina, United States
Institution of OriginUniversity of Southern Queensland
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