Retinopathy and Cardiovascular Risk: Dose-Dependent Relationship

Retinopathy and Cardiovascular Risk: Dose-Dependen

Research Highlights:

In a large national survey, people with retinal damage were more likely to have had a stroke or dementia.
The more severe the damage to the retina, the more likely the participants were to die in the next decade.
The findings raise the possibility that retinal scans could help identify people at higher risk of stroke or dementia, so that preventative care can be offered.

Retinal images may one day provide early warning signs that a person is at increased risk of stroke and dementia, making it possible to take preventive measures, according to preliminary research to be presented at the American Stroke Association. International Stroke Conference 2021. The virtual meeting is a world-class meeting for researchers and clinicians dedicated to the science of stroke and brain health.

Studies have shown that people with severe retinopathy, damage to light-sensitive tissue, are more likely to have a diseased-looking brain on magnetic resonance imaging (MRI).

“The retina is a window to the brain,” said Michelle P. Lin, MD, MPH, lead author of the study and a neurologist at Mayo Clinic Jacksonville in Jacksonville, Florida. “A photo of the retina that shows a magnified look at the back of the eye, including the retina and optic nerve, is cheaper and faster to perform than an MRI, so we wondered if it could be a good screening tool. screening to see who might benefit from a referral to a neurologist for a brain MRI."

In addition to the eye doctor’s office, photos of the retina can be taken with a smartphone camera or a smartphone adapter, Lin said.

In this study, researchers examined the association of retinopathy with stroke, dementia, and risk of death in 5,543 adults (average age 56 years) who participated in the annual National Health and Nutrition Examination Survey (NHANES). of the US between 2005 and 2008.

Participants during those years were interviewed about many aspects of their medical history and health behaviors, and in addition, received a retinal scan photo to look for signs of retinopathy.

Compared to participants not diagnosed with retinopathy, those with retinopathy were:

More than twice as likely to have had a stroke.
Almost 70% more likely to have dementia.
They were more likely to die in the next 10 years, and each increase in the severity of retinopathy conferred a higher risk of death.
The odds were calculated after adjusting for risk factors such as age, high blood pressure, diabetes and smoking.

“If you have retinopathy, work closely with your primary care doctor to modify your vascular risk factors and ask to be screened for cognitive impairment. You may be referred to a neurologist for an evaluation and possibly a brain MRI,” said Lin, who is also an assistant professor of neurology at Mayo Clinic School of Medicine.

The study is limited because the NHANES data do not differentiate between various types of stroke. Additionally, because the surveys rely on self-reported memory problems as an indicator of dementia, the occurrence of dementia may be overestimated.

Co-authors are Daniela Markovic, MS.; Nilufer Ertekin-Taner, M.D., Ph.D.; Eric R. Eggenberger, D.O.; Michael W. Stewart, M.D.; Thomas G. Brott, M.D.; and James Meschia, MD Author disclosures are available in summary.

The study was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health.

Retinopathy and Cardiovascular Risk: Dose-Dependent Relationship

Severity of retinopathy shows a dose-dependent relationship with all-cause mortality, emphasizing the prognostic significance of retinal microvascular changes and their association with systemic vascular health outcomes.