Related Experiment Video
Updated: Aug 14, 2026
Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies
Published on: October 22, 2014
Retinal microvascular abnormalities and MRI-defined subclinical cerebral infarction: the Atherosclerosis Risk in
Lawton S Cooper1, Tien Y Wong, Ronald Klein
1National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Background And Purpose:
Retinal microvascular abnormalities reflect cumulative small vessel damage from elevated blood pressure and may reflect subclinical cerebral microvascular changes. We examined their associations with MRI-defined cerebral infarcts.
Methods:
Population-based, cross-sectional study of 1684 persons 55 to 74 years of age without a history of clinical stroke, sampled from 2 US southeastern communities. Retinal photographs were obtained and graded for presence of retinal microvascular abnormalities, including arteriovenous nicking, focal arteriolar narrowing, retinal hemorrhages, soft exudates and microaneurysms. Photographs were also digitized, and retinal vessel diameters were measured and summarized as the arteriole-to-venule ratio (AVR). Cerebral MRI scans were graded for presence of cerebral infarct, defined as a lesion > or =3 mm diameter in a vascular distribution with typical imaging characteristics.
Results:
There were a total of 183 MRI cerebral infarcts. After adjustment for age, gender, race, 6-year mean arterial blood pressure, diabetes, and other stroke risk factors, cerebral infarcts were associated with retinal microvascular abnormalities, with odds ratios 1.90 (95% CI, 1.25 to 2.88) for arteriovenous nicking, 1.89 (95% CI, 1.22 to 2.92) for focal arteriolar narrowing, 2.95 (95% CI, 1.30 to 6.71) for blot hemorrhages, 2.08 (95% CI, 0.69, 6.31) for soft exudates, 3.17 (95% CI, 1.05 to 9.64) for microaneurysms, and 1.74 (95% CI, 0.95 to 3.21) for smallest compared with largest AVR. In stratified analyses, these associations were only present in persons with hypertension.
Conclusions:
Retinal microvascular abnormalities are associated with MRI-defined subclinical cerebral infarcts independent of stroke risk factors. These data suggest that retinal photography may be useful for studying subclinical cerebrovascular disease in population-based studies.
Insights
Retinal microvascular abnormalities, like arteriovenous nicking and narrowing, are linked to silent brain infarcts. These findings suggest retinal photography can help study subclinical cerebrovascular disease.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Biology
Background:
- Retinal microvascular changes may indicate cumulative small vessel damage from hypertension.
- These changes might reflect subclinical changes in the brain's small vessels.
Purpose of the Study:
- To investigate the association between retinal microvascular abnormalities and cerebral infarcts detected by MRI.
Main Methods:
- A population-based study of 1684 individuals aged 55-74 without a history of stroke.
- Retinal photographs were graded for abnormalities (e.g., arteriovenous nicking, focal arteriolar narrowing, hemorrhages, exudates, microaneurysms) and vessel diameters (arteriole-to-venule ratio).
- Cerebral MRI scans were assessed for infarcts (lesions ≥3 mm).
Main Results:
- 183 cerebral infarcts were identified.
- Retinal microvascular abnormalities were associated with cerebral infarcts after adjusting for risk factors.
- Specific associations included arteriovenous nicking (OR 1.90), focal arteriolar narrowing (OR 1.89), blot hemorrhages (OR 2.95), and microaneurysms (OR 3.17).
- These associations were primarily observed in individuals with hypertension.
Conclusions:
- Retinal microvascular abnormalities are independently associated with subclinical cerebral infarcts.
- Retinal photography may serve as a valuable tool for population-based studies of cerebrovascular disease.
Related Concept Videos
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:27Diabetic Retinopathy