Purpose
To explore the correlation between fundus changes and the risk of cerebral stroke, and to find out the risk factors or early-warming indicators for stroke.
Methods
This is a case-control study. 450 patients with cerebral stroke (stroke group) and 566 non-stroke subjects (controlled group) selected from Beijing Eye Study were enrolled. Two groups matched for age. 1016 cases of fundus photographs were evaluated to find out the correlation between fundus indicators and the risk of stroke. Main outcome measures were retinal nerve fiber layer defect (RNFLD), retinal microvascular abnormalities (arterial narrowing, vein dilatation), retinopathy (cotton wool spot, and retinal hemorrhage), optic nerve changes and macular diseases.Logistic regression statistic method was used to analysis the correlation between fundus changes and stroke. Orange 2 analysis software was used to visualization the data results.
Results
The mean age of stroke group was (63.64+10.16) years old, 258 males (57.3%), 192 females (42.7%). The mean age of non-stroke group was (62.45+8.68) years old, 250 males (44.2%), 316 females (55.8%). Two groups matched for age (P=0.063). Gender, RNFLD, retinal vein dilatation, macular diseases were correlated with stroke significantly (P=0.000), RNFLD (OR=4.163, 95%CI 2.792-6.208) and retinal vein dilatation (OR=3.443, 95%CI 2.333-5.082) were highly correlated with stroke particularly. Except for gender having negative correlation with stroke (being compared with females, males a for more cases susceptible risk to stroke), RNFLD and retinal vein dilatation, macular diseases having positive correlation with stroke. Fundus indicators of retinal arterial narrowing, vein dilatation and RNFLD coexisting were correlated with high risk of stroke.
Conclusions
RNFLD, retinal arterial narrowing, vein dilatation correlated with high risk of cerebral stroke, can be regarded as early-warming indicators for stroke. Fundus changes reflect cerebrovascular changes relating to stroke. The ability to assess the retinal circulation and nerve fiber layer in vivo offers potential advantages over other cerebral imaging techniques, which tend to be expensive and not necessarily widely available.