Prevalence of Asymptomatic Retinal Emboli in an Australian Urban Community

Abstract

This study provides accurate prevalence rates for asymptomatic retinal emboli in the elderly and confirms associations with hypertension, smoking, and vascular disease.

Ten-Year Incidence of Retinal Emboli in an Older Population

“…8,12 We found no significant gender difference in embolus incidence, contrasting with previous reports. 8,9,12 Our data confirm previous reported associations between retinal emboli and traditional cardiovascular risk factors, including hypertension, 8 -11 smoking, 8 -12 hypercholesterolemia, 3,8 -12 and plasma fibrinogen. 8,9,11,12 In hypertensive subjects who smoked, a 4.4-fold risk of emboli over nonsmokers …”

“…13 Photographs were assessed for embolus type (cholesterol, fibrin-platelet, calcific), number, location and size, 9 and retinal vascular signs (focal arteriolar narrowing, arteriovenous [AV] nicking, opacification of the arteriolar wall), and presence of retinopathy lesions. 14 At baseline, we measured blood pressure (BP) and defined mean arterial BP (MABP) as one third systolic BP (SBP)ϩtwo thirds diastolic BP (DBP), severe hypertension if SBP Ն160 mm Hg/DBP Ն100 mm Hg or use of antihypertensive medications, and overweight if body mass index Ն25.…”

“…8 -11 Only the Beaver Dam Eye Study (BDES) has reported 5-and 10-year incidence from a population-based sample. 8,12 We previously reported a 1.4% prevalence of retinal emboli in an older Australian population 9 and now aim to assess 10-year incidence and predictors of retinal emboli in the same population.…”

Coronary Catheterisation Does Not Lead to Retinal Artery Emboli in Short-Term Follow-Up of Cardiac Patients

“…We found that 5.2% of cardiac patients had asymptomatic retinal emboli before coronary catheterization, which is substantially higher than the reported prevalence of 1.4% found in a general older Australian population 9 (Table). This finding suggests that patients undergoing cardiac catheterization may also have an increased risk of stroke, as retinal emboli are known to predict higher stroke risk.…”

Symptomatic and Asymptomatic Retinal Embolism Have Different Mechanisms

“…1,2 Retinal emboli, particularly cholesterol emboli (Hollenhorst plaques), are frequently observed in asymptomatic patients and are associated with an increased risk for stroke and vascular death, but not with ICA lesions. [3][4][5][6] Transcranial Doppler ultrasonography (TCD) studies have demonstrated microembolic signals (MES) in the basal vessels of the brain in patients with cerebral and retinal ischemia, cardioembolic lesions, and ICA stenosis. [7][8][9][10] MES are common in patients with retinal ischemia and are associated with ICA stenosis in these patients.…”