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M. K. Ikram, R. Wieberdink, P. Koudstaal, A. Hofman, J. R. Vingerling, M. Breteler; Retinal Vascular Caliber and Risk of Intracerebral Haemorrhage. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1241.
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Narrower retinal arterioles and wider venules predict incident cardiovascular disease, including cerebral infarction. However, there are no data on the association between retinal vascular caliber and intra-cerebral haemorrhage. We examined whether smaller retinal arteriolar or larger venular caliber were associated with incident intra-cerebral haemorrhage.
This study was part of the on-going Rotterdam Study, a large population-based cohort study among participants aged 55 years and older. A total of 5518 participants were included who were free of stroke at baseline (1990-1993) and had gradable digitized fundus photographs for retinal vascular caliber measurements. For each participant, summary retinal arteriolar and venular calibers were measured on these digitized images of one eye using a semi-automated system. Follow-up for incident stroke was complete up to January 1, 2007. Data were analyzed with Cox proportional hazards models adjusted for age and sex, and additionally for other known cardiovascular risk factors. Arteriolar and venular calibers were entered simultaneously in each of the models.
During an average follow-up time of 11.7 years, 623 participants developed a first-ever stroke, of whom 61 had intra-cerebral haemorrhage. Larger venular caliber was associated with an increased risk of stroke [fully-adjusted hazard ratio (HR) per standard deviation (SD) increase: 1.20; 95% confidence interval (CI): 1.09-1.32] and intra-cerebral haemorrhage [HR per SD increase: 1.43; 95% CI: 1.05-1.95]. The corresponding HR for arteriolar caliber per SD decrease were 1.10 [95% CI: 0.99-1.21] and 1.20 [95% CI: 0.88-1.65].
In this population-based study, larger retinal venular caliber was associated with an increased risk of stroke and - more specifically - its subtype intra-cerebral haemorrhage.
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