Journal ArticleDOI
Retinal microvascular signs and risk of stroke and stroke mortality
TLDR
In older Australians without diabetes, retinopathy signs predict stroke or stroke-related death independent of traditional stroke risk factors.Abstract:
Objective: The purpose of this study was to assess the relation of retinal microvascular signs and incident stroke and stroke mortality in an older population. Methods: The authors took retinal photographs on baseline participants (3,654 patients aged 49+ years) of the Blue Mountains Eye Study (1992 to 1994). They assessed the presence of retinopathy (microaneurysms, retinal hemorrhages) in participants without diabetes and retinal arteriolar signs in all participants using standardized grading protocols. Incident stroke/TIA/cerebrovascular death (combined stroke events) were identified at follow-up examinations during 1997 to 1999. Results: During a 7-year period, 859 participants died, 97 (11.3%) of which died of cerebrovascular causes. Of survivors, 24 had confirmed incident stroke, and 11 had incident TIA. Combined stroke events were more frequent in participants with retinopathy (5.7%), with moderate/severe arteriovenous nicking (4.2%), or with focal arteriolar narrowing (7.2%) compared with those without (1.9%). After controlling for age, sex, systolic blood pressure, smoking, and self-rated health, retinopathy was significantly associated with combined stroke events (relative risk [RR] 1.7, 95% CI 1.0 to 2.8) in persons without diabetes. This association was stronger in those without severe hypertension (RR 2.7, CI 1.2 to 6.2) or in persons with two or more retinal microvascular signs (RR 2.7, CI 1.5 to 5.2). Generalized or focal arteriolar narrowing or arteriovenous nicking was not independently associated with combined stroke events after multivariate adjustment. Conclusions: In older Australians without diabetes, retinopathy signs predict stroke or stroke-related death independent of traditional stroke risk factors.read more
Citations
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Journal ArticleDOI
Ranibizumab for neovascular age-related macular degeneration.
Gerald Liew,Paul Mitchell +1 more
Journal ArticleDOI
Genome-Wide Association Study of Retinopathy in Individuals Without Diabetes
Richard A. Jensen,Xueling Sim,Xiaohui Li,Mary Frances Cotch,M. Kamran Ikram,Elizabeth G. Holliday,Gudny Eiriksdottir,Tamara B. Harris,Fridbert Jonasson,Barbara E.K. Klein,Lenore J. Launer,Albert V. Smith,Eric Boerwinkle,Ning Cheung,Alex W. Hewitt,Gerald Liew,Paul Mitchell,Jie Jin Wang,John Attia,Rodney J. Scott,Nicole L. Glazer,Thomas Lumley,Barbara McKnight,Bruce M. Psaty,Kent D. Taylor,Albert Hofman,Paulus T. V. M. de Jong,Fernando Rivadeneira,André G. Uitterlinden,Wan Ting Tay,Yik Ying Teo,Mark Seielstad,Jianjun Liu,Ching-Yu Cheng,Seang-Mei Saw,Tin Aung,Santhi K. Ganesh,Christopher J. O'Donnell,Mike A. Nalls,Kerri L. Wiggins,Jane Z. Kuo,Cornelia M. van Duijn,Vilmundur Gudnason,Ronald Klein,David S. Siscovick,Jerome I. Rotter,E. Shong Tai,Johannes R. Vingerling,Tien Yin Wong +48 more
TL;DR: This genome-wide association study of retinopathy in individuals without diabetes showed little evidence of genetic associations and further studies are needed to identify genes associated with these signs in order to help unravel novel pathways and determinants of microvascular diseases.
Journal ArticleDOI
Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum?
TL;DR: It is imperative to understand whether microvascular complications distinctly precede macrov vascular complications or do both of them progress simultaneously as a continuum to allow re-focusing on the clinical issues with a unifying perspective which can improve type 2 diabetes mellitus outcomes.
Journal ArticleDOI
The eye in hypertension.
Tien Yin Wong,Paul Mitchell +1 more
TL;DR: Recognition of the ocular effects of blood pressure could allow physicians to better manage patients with hypertension, and to monitor its end-organ effects.
Journal ArticleDOI
Retinal vascular caliber: systemic, environmental and genetic associations
Cong Sun,Jie Jin Wang,Jie Jin Wang,David A. Mackey,David A. Mackey,Tien Yin Wong,Tien Yin Wong +6 more
TL;DR: Elucidating the complete range of systemic, environmental, and genetic factors linked with retinal vascular caliber changes may provide critical insight into the etiology, pathogenesis, and natural history of early vascular disease not only in the eye but across the body.
References
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Journal ArticleDOI
The Wisconsin age-related maculopathy grading system.
Ronald Klein,Matthew D. Davis,Yvonne L. Magli,Paul Segal,Barbara E.K. Klein,Larry D. Hubbard +5 more
TL;DR: A new system for grading age-related maculopathy using stereoscopic 30 degrees color fundus photographs, standard circles printed on plastic to assess size and area, and a specially designed lightbox to allow better discrimination of subtle drusen is described and measures of reliability are reported.
Journal ArticleDOI
Prevalence of Age-related Maculopathy in Australia: The Blue Mountains Eye Study
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Journal ArticleDOI
Retinal microvascular abnormalities and incident stroke: the Atherosclerosis Risk in Communities Study.
Tien Yin Wong,Tien Yin Wong,Ronald Klein,David Couper,Lawton S. Cooper,Eyal Shahar,Larry D. Hubbard,Marion R. Wofford,A. Richey Sharrett +8 more
TL;DR: Most retinal microvascular characteristics were predictive of incident stroke, and the associations were similar for ischaemic strokes specifically, and for strokes in individuals with hypertension, either with or without diabetes.
Journal ArticleDOI
Retinal microvascular abnormalities and their relationship with hypertension, cardiovascular disease, and mortality.
Tien Yin Wong,Tien Yin Wong,Tien Yin Wong,Ronald Klein,Barbara E.K. Klein,James M. Tielsch,Larry D. Hubbard,F. Javier Nieto +7 more
TL;DR: There is no convincing evidence of an independent or direct association with atherosclerosis, ischemic heart disease, or cardiovascular mortality, but when reliably quantified, retinal microvascular abnormalities may be useful as risk indicators for cerebrovascular diseases.
Journal ArticleDOI
Is Breakdown of the Blood-Brain Barrier Responsible for Lacunar Stroke, Leukoaraiosis, and Dementia?
TL;DR: In this paper, the authors hypothesize that cerebral small-vessel endothelial dysfunction, with leakage of plasma components into the vessel wall and surrounding brain tissue leading to neuronal damage, may contribute to the development of three overlapping and disabling cerebrovascular conditions: lacunar stroke, leukoaraiosis, and dementia.