Relation between retinal vessel diameters and carotid artery stenosis patients with cerebral infarction_Chinese Journal of Ocular Fundus Diseases

Authors：

ZhaoLu , XieGuoli , WangJialin ,  WangYanling

Beijing Friendship Hospital, Capital Medical University, Department of Ophthalmology, Beijing 100050, China;

Corresponding author：

WangYanling, Email: wangyanling999@sina.com

Keywords：

Retinal vessels/physiopathology; Carotid stenosis/complications; Brain infarction/etiology

DOI：

10.3760/cma.j.issn.1005-1015.2016.04.010

Video：

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Objective To investigate the relationship between retinal vessel diameters and cerebral infarction of carotid artery stenosis patients. Methods Eighty-seven patients (174 eyes) with carotid stenosis were included in this study. There were 49 males and 38 females, with an average age of (65.25±7.85) years. Thirty-four patients were suffered from cerebral infarction (cerebral infarction group), and the other 53 patients had no cerebral infarction (control group). There was no significant difference in age (t=1.916), male rate (χ²=0.142) and carotid stenosis extent (χ²=0.785) between the two groups (P=0.059, 0.706, 0.675). All patients underwent color fundus photography after mydriasis. Retinal vascular caliber measurements were performed using IVAN software. The main parameters were central retinal artery diameter (central retinal artery equivalent, CRAE), the diameter of the central retinal vein (central retinal vein equivalent, CRVE) and the retinal arteriole to venular ratio (AVR). The relationship between retinal vessel diameter and cerebral vascular disease were analyzed with logistic regression analysis. Results In cerebral infarction group, CRVE, CRAE and AVR ratios were (132.90±20.67) μm, (243.47±43.92) μm and 0.56±0.10, while the control group was (145.26±21.59) μm, (224.99±32.35) μm and 0.68±0.13 respectively. There were significant differences between the two groups (t=-2.648, 2.257, -4.631; P < 0.05). After correction for risk factors, such as age, smoking history, CRAE reduction and CRVE increases were significantly correlated with cerebral infarction. Conclusion CRAE reduction and CRVE increases are risk factors of cerebral infarction in patients with carotid stenosis, and it is useful in the prediction.

Citation： ZhaoLu, XieGuoli, WangJialin, WangYanling. Relation between retinal vessel diameters and carotid artery stenosis patients with cerebral infarction. Chinese Journal of Ocular Fundus Diseases, 2016, 32(4): 387-390. doi: 10.3760/cma.j.issn.1005-1015.2016.04.010 Copy

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7.	Yatsuya H, Folsom AR, Wong TY, et al.ARIC Study Investigators. Retinal microvascular abnormalities and risk of lacunar stroke:atherosclerosis risk in communities study[J]. Stroke, 2010,41(7):1349-1355.DOI:10.1161/STROKEAHA.110.580837.
8.	Wong TY, Klein R, Sharrett AR, et al. The prevalence and risk factors of retinal microvascular abnormalities in older persons:the Cardiovascular Health Study[J].Ophthalmology,2003,110(4):658-666. DOI:10.1016/S0161-6420(02)01931-0.
9.	Klein R, Klein BE, Jensen SC, et al. Retinal emboli and stroke:the Beaver Dam Eye Study[J]. Arch Ophthalmol,1999,117(8):1063-1068.
10.	Lindley RI, Wang JJ,Wong MC, et al.Retinal microvasculature in acute lacunar stroke:a cross-sectional study[J]. Lancet Neurol,2009,8(7):628-634.DOI:10.1016/S1474-4422(09)70131-0.
11.	Ikram MK, De Jong FJ, Van Dijk EJ, et al. Retinal vessel diameters and cerebral small vessel disease:the Rotterdam Scan Study[J]. Brain, 2006,129(Pt 1):182-188.
12.	覃静. 视网膜血管异常与缺血性脑血管疾病相关性的流行病学调查[J].北京医学, 2008, 30(9):516-518.DOI:10.3969/j.issn.0253-9713.2008.09.002. Tan J.Epidemiologic surveg of the relation between retinal vessel abnormality and ischemic cerebrovascular disease[J].Beijing Medical Journal,2008,30(9):516-518. DOI:10.3969/j.issn.0253-9713.2008.09.002.
13.	Klijn CJ, Kappelle LJ, van Schooneveld MJ, et al. Venous stasis retinopathy in symptomatic carotid artery occlusion:prevalence, cause, and outcome[J]. Stroke, 2002,33(3):695-701.
14.	Klein R, Klein BE, Knudtson MD, et al. Are inflammatory factors related to retinal vessel caliber? The Beaver Dam Eye Study[J]. Arch Ophthalmol,2006,124(1):87-94.
15.	Wong TY, Islam FM, Klein R, et al. Retinal vascular caliber, cardiovascular risk factors, and inflammation:themulti-ethnic study of atherosclerosis (MESA)[J]. Invest Ophthalmol Vis Sci, 2006,47(6):2341-2350.

1. de Lau LM, van Meurs JB, Uitterlinden AG, et al. Genetic variation in homocysteine metabolism, cognition, and white matter lesions[J]. Neurobiol Aging, 2010,31(11):2020-2022.DOI:10.1016/j.neurobiolaging.2008.10.004.
2. 陈旭羚, 杨柳.高血压视网膜病变与颈动脉病变相关性研究[J].中华眼底病杂志,2016,32(3):326-330. DOI:10.3760/cma.j.issn.1005-1015.2016.03.027. Chen XL,Yang L.Research updates on the correlation of hypertensive retinopathy and carotid artery lesion[J].Chin J Ocul Fundus Dis, 2016,32(3):326-330. DOI:10.3760/cma.j.issn.1005-1015.2016.03.027.
3. 脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):381.Scale standard of defect degree in clinical neurological functions in cerebral apoplexy patients(1995)[J].Chin J Neurol,1996,29(6):381.
4. Knudtson MD, Lee KE, Hubbard LD,et al.Revised formulas for summarizing retinal vessel diameters[J].Curr Eye Res, 2003,27(3):143-149.
5. Doubal FN, MacGillivray TJ, Hokke PE, et al.Differences in retinal vessels support a distinct vasculopathy causing lacunar stroke[J]. Neurology,2009,72(20):1773-1778.DOI:10.1212/WNL.0b013e3181a60a71.
6. 朱伟谦, 李佳,翁益云,等.缺血性脑血管病患者白质病变与视网膜血管病的相关性[J].中国神经免疫学和神经病学杂志,2013, 20(3):184-187.DOI:10.3969/j.issn.1006-2963.2013.03.009. Zhu WQ,Li J,Weng YY,et al Relationship of white matter lesions to retinal angiopathy in patients with ischemic cerebrovascular disease[J].Chin J Neuroimmunol & Neurol, 2013, 20(3):184-187. DOI:10.3969/j.issn.1006-2963.2013.03.009.
7. Yatsuya H, Folsom AR, Wong TY, et al.ARIC Study Investigators. Retinal microvascular abnormalities and risk of lacunar stroke:atherosclerosis risk in communities study[J]. Stroke, 2010,41(7):1349-1355.DOI:10.1161/STROKEAHA.110.580837.
8. Wong TY, Klein R, Sharrett AR, et al. The prevalence and risk factors of retinal microvascular abnormalities in older persons:the Cardiovascular Health Study[J].Ophthalmology,2003,110(4):658-666. DOI:10.1016/S0161-6420(02)01931-0.
9. Klein R, Klein BE, Jensen SC, et al. Retinal emboli and stroke:the Beaver Dam Eye Study[J]. Arch Ophthalmol,1999,117(8):1063-1068.
10. Lindley RI, Wang JJ,Wong MC, et al.Retinal microvasculature in acute lacunar stroke:a cross-sectional study[J]. Lancet Neurol,2009,8(7):628-634.DOI:10.1016/S1474-4422(09)70131-0.
11. Ikram MK, De Jong FJ, Van Dijk EJ, et al. Retinal vessel diameters and cerebral small vessel disease:the Rotterdam Scan Study[J]. Brain, 2006,129(Pt 1):182-188.
12. 覃静. 视网膜血管异常与缺血性脑血管疾病相关性的流行病学调查[J].北京医学, 2008, 30(9):516-518.DOI:10.3969/j.issn.0253-9713.2008.09.002. Tan J.Epidemiologic surveg of the relation between retinal vessel abnormality and ischemic cerebrovascular disease[J].Beijing Medical Journal,2008,30(9):516-518. DOI:10.3969/j.issn.0253-9713.2008.09.002.
13. Klijn CJ, Kappelle LJ, van Schooneveld MJ, et al. Venous stasis retinopathy in symptomatic carotid artery occlusion:prevalence, cause, and outcome[J]. Stroke, 2002,33(3):695-701.
14. Klein R, Klein BE, Knudtson MD, et al. Are inflammatory factors related to retinal vessel caliber? The Beaver Dam Eye Study[J]. Arch Ophthalmol,2006,124(1):87-94.
15. Wong TY, Islam FM, Klein R, et al. Retinal vascular caliber, cardiovascular risk factors, and inflammation:themulti-ethnic study of atherosclerosis (MESA)[J]. Invest Ophthalmol Vis Sci, 2006,47(6):2341-2350.

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