Microvascular structure and network in the retina of patients with ischemic stroke.
Stroke
; 44(8): 2121-7, 2013 Aug.
Article
en En
| MEDLINE
| ID: mdl-23715958
ABSTRACT
BACKGROUND AND PURPOSE:
Microvascular disease has been implicated in the pathogenesis of stroke. The retina provides a window to assess microcirculation noninvasively. We studied the association between quantitatively measured retinal microvascular characteristics and acute ischemic stroke.METHODS:
We conducted a case-control study with acute ischemic stroke patients recruited from a tertiary hospital in Singapore and controls from the Singapore Epidemiology of Eye Disease program matched by 10-year age strata, sex, and race. Strokes were classified using modified Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Retinal vascular parameters were measured from retinal fundus photographs using a computer program. Logistic regression models for stroke were constructed adjusting for age, sex, race, and additionally for smoking, hypertension, diabetes mellitus, and hypercholesterolemia.RESULTS:
We included 557 ischemic stroke cases (261 lacunar, 185 large artery, and 54 cardioembolic stroke) and 557 controls. After adjusting for vascular risk factors, decreased arteriolar fractal dimension (odds ratio [OR] per standard deviation [SD] decrease, 2.28; 95% confidence interval [CI], 1.80-2.87) and venular fractal dimension (OR per SD decrease, 1.80; 95% CI, 1.46-2.23), increased arteriolar tortuosity (OR per SD increase, 1.56; 95% CI, 1.25-1.95), and venular tortuosity (OR per SD increase, 1.49; 95% CI, 1.27-1.76), narrower arteriolar caliber (OR per SD decrease, 2.79; 95% CI, 2.21-3.53), and wider venular caliber (OR per SD increase, 1.57; 95% CI, 1.27-1.95) were associated with stroke. Stratification by stroke subtypes and further adjustment for retinopathy signs revealed similar results.CONCLUSIONS:
Patients with ischemic stroke have a sparser and more tortuous microvascular network in the retina. These findings provide insight into the structure and pattern of microcirculation changes in stroke.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Retina
/
Vasos Retinianos
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Isquemia Encefálica
/
Accidente Cerebrovascular
/
Retinoscopía
/
Microvasos
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Stroke
Año:
2013
Tipo del documento:
Article
País de afiliación:
Singapur