TY - JOUR
T1 - Retinal microvascular abnormalities predict progression of brain microvascular disease
T2 - An atherosclerosis risk in communities magnetic resonance imaging study
AU - Hanff, Thomas C.
AU - Sharrett, A. Richey
AU - Mosley, Thomas H.
AU - Shibata, Dean
AU - Knopman, David S.
AU - Klein, Ronald
AU - Klein, Barbara E.K.
AU - Gottesman, Rebecca F.
PY - 2014/4
Y1 - 2014/4
N2 - BACKGROUND AND PURPOSE - : Brain microvascular disease leads to leukoaraiosis and lacunar infarcts and contributes to risk of stroke and cognitive decline. Given a shared pathophysiology, retinal microvascular signs are expected to predict brain microvascular disease progression. We investigated if either leukoaraiosis volume progression measured continuously or combined with incident lacunar infarcts would better demonstrate expected associations with retinal disease than has previously been shown. METHODS - : Eight hundred thirty participants in the Atherosclerosis Risk in Communities (ARIC) study aged ≥55 years and without previous stroke received an initial brain magnetic resonance imaging, retinal photography, and, 10 years later, a follow up magnetic resonance imaging. We evaluated retinal vascular sign phenotypes as predictors of (1) leukoaraiosis volume increase, and (2) a new score combining leukoaraiosis volume change and incident lacunar infarcts. Hypertension and diabetes mellitus were evaluated as confounders and effect modifiers. RESULTS - : Individuals with any retinopathy (3.34 cm; 95% confidence interval [CI], 0.74-5.96) or with arteriovenous nicking (2.61 cm; 95% CI, 0.80-4.42) each had greater progression of leukoaraiosis compared with those without these conditions. Any retinopathy (odds ratio [OR], 3.18; 95% CI, 1.71-5.89) or its components - microaneurysms (OR, 3.06; 95% CI, 1.33-7.07) and retinal hemorrhage (OR, 3.02; 95% CI, 1.27-7.20) - as well as arteriovenous nicking (OR, 1.93; 95%, CI 1.24-3.02) and focal arteriolar narrowing (OR, 1.76; 95% CI, 1.19-2.59), were associated with a higher quartile of a novel brain microvascular disease score combining leukoaraiosis progression with incident subclinical lacunes. CONCLUSIONS - : A novel scoring method revealed associations of retinal signs with leukoaraiosis progression and brain microvascular disease, which have not been shown before.
AB - BACKGROUND AND PURPOSE - : Brain microvascular disease leads to leukoaraiosis and lacunar infarcts and contributes to risk of stroke and cognitive decline. Given a shared pathophysiology, retinal microvascular signs are expected to predict brain microvascular disease progression. We investigated if either leukoaraiosis volume progression measured continuously or combined with incident lacunar infarcts would better demonstrate expected associations with retinal disease than has previously been shown. METHODS - : Eight hundred thirty participants in the Atherosclerosis Risk in Communities (ARIC) study aged ≥55 years and without previous stroke received an initial brain magnetic resonance imaging, retinal photography, and, 10 years later, a follow up magnetic resonance imaging. We evaluated retinal vascular sign phenotypes as predictors of (1) leukoaraiosis volume increase, and (2) a new score combining leukoaraiosis volume change and incident lacunar infarcts. Hypertension and diabetes mellitus were evaluated as confounders and effect modifiers. RESULTS - : Individuals with any retinopathy (3.34 cm; 95% confidence interval [CI], 0.74-5.96) or with arteriovenous nicking (2.61 cm; 95% CI, 0.80-4.42) each had greater progression of leukoaraiosis compared with those without these conditions. Any retinopathy (odds ratio [OR], 3.18; 95% CI, 1.71-5.89) or its components - microaneurysms (OR, 3.06; 95% CI, 1.33-7.07) and retinal hemorrhage (OR, 3.02; 95% CI, 1.27-7.20) - as well as arteriovenous nicking (OR, 1.93; 95%, CI 1.24-3.02) and focal arteriolar narrowing (OR, 1.76; 95% CI, 1.19-2.59), were associated with a higher quartile of a novel brain microvascular disease score combining leukoaraiosis progression with incident subclinical lacunes. CONCLUSIONS - : A novel scoring method revealed associations of retinal signs with leukoaraiosis progression and brain microvascular disease, which have not been shown before.
KW - Leukoaraiosis
KW - Retina
UR - http://www.scopus.com/inward/record.url?scp=84897419417&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897419417&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.113.004166
DO - 10.1161/STROKEAHA.113.004166
M3 - Article
C2 - 24549866
AN - SCOPUS:84897419417
SN - 0039-2499
VL - 45
SP - 1012
EP - 1017
JO - Stroke
JF - Stroke
IS - 4
ER -