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Study: Retinal vascular abnormalities associated with ‘silent stroke’
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Certain blood vessel abnormalities in the retina are associated with silent strokes, a study has found.
Lawton S. Cooper, MD, MPH, and colleagues investigated whether abnormalities in small blood vessels in the eye might indicate the presence of silent cerebral infarctions, or silent strokes . This is “a type of stroke that most people are not aware that they have had,” Dr. Cooper said in a press release from the American Stroke Association.
The study, which was funded by the National Heart, Lung and Blood Institute, where Dr. Cooper is a medical officer, is published in Stroke: Journal of the American Heart Association.
The retinal vasculature, which can be observed noninvasively, allows researchers to examine the long-term effects of high blood pressure, a risk factor for stroke, the press release said.
The abnormalities investigated in the study were the presence of arteriovenous nicking, focal arteriolar narrowing, blot hemorrhages, soft exudates and microaneurysms, the press release said. Abnormalities in the small retinal vessels may not produce ocular symptoms, and they are “rarely detected on routine eye exams” if they are mild or moderate, the release noted.
The researchers analyzed data from 1,684 people between the ages of 55 and 74 who were sampled from the Atherosclerosis Risk in Communities Study population. None of the participants had a history of stroke. Retinal photographs were taken, and cerebral MRI was performed to look for cerebral infarcts.
As identified by MRI, 183 people in the study had cerebral infarcts. Participants with arteriovenous nicking, focal arteriolar narrowing or soft exudates were about twice as likely to have cerebral infarcts as those who did not have the ocular abnormalities, the release noted. Participants with blot hemorrhages or microaneurysms were about three times more likely to have cerebral infarcts than those without the abnormalities. The risks were “even higher” when the study sample was narrowed to only people with high blood pressure.
For now, these findings imply no need for a change in clinical practice, according to the press release. “Future studies are needed to look at whether detecting these changes in the eye can lead to stroke prevention,” the release said.
Dr. Cooper said the study has shown the value of retinal photography as a research tool for studying stroke, and he called for “more clinically based research into how useful these photographs might be for preventing stroke.”