The association between retinal vasculature changes and stroke: a literature review and Meta-analysis

Wu, Huiqun; Shi, Lili; Yu, Liyuan; Wang, Liyuan; Chen, Yalan; Geng, Jinsong; Shi, Jianzhong; Jiang, Kui; Dong, Jiancheng

doi:10.18240/ijo.2017.01.18

Cited by 23 publications

(21 citation statements)

References 31 publications

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“…Also in another study by Wang et al, who used the diameter as a value in measuring smaller retinal arterioles as well as that of larger venules as a predictor of assessment of severity CAD and stroke mortality. This study concluded that the diameter of retinal vessel could be used as a predictor of CAD risk and stroke-related mortality in middle-aged persons, but unfortunately we can't use that value of vessel caliber changes in the present study [12,13].…”

Section: Discussionmentioning

confidence: 85%

Hypertensive Retinopathy can Predict Severity of Coronary Artery Disease in Hypertensive Patients Presenting with Angina

Asklany¹,

Mohamed²,

Genidy³

et al. 2018

J Hypertens

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pain, were referred to do Stress Electrocardiography (ECG), 50 of them were negative test and excluded while the remaining 150 patients were positive or equivocal stress ECG. 70 patients were not willing to join the study, but the remaining 80 patients who gave informed consent were included. The included 80 patients referred for ophthalmoscopy examination before undergoing coronary angiography. Excluded patients were those with Diabetes mellitus, past history of ischemic heart disease, presence of nephropathy (creatinine more than 1.5 mg/ dL), and previous coronary angiography.All included patients were subjected to:1. Full data history, local cardiac and general examination. 12-Lead surface ECG. AbstractBackground: Hypertension cause injures to blood vessels, which may be macro vascular like coronary artery or micro vascular like retinal artery. Retina is the only place in the body where micro vascular damage can be observed directly. Retinal microvascular changes could be a suitable window to detect changes related to the pathophysiological changes that occurred in coronary artery disease as well as hypertension.Objective: To assess the relationship between retinal micro vascular changes and angiographic findings in hypertensive patients presenting with angina. Methods:A prospective study was done over one year including 80 patients known to be hypertensive for whom stress test was positive and or equivocal for angina diagnosis were referred to ophthalmology clinic to assess retinal atherosclerosis and its severity based on the Scheie classification after that the coronaries lesions and the extent of its severity was assessed by coronary angiography using Gensini and also the modified Gensini score. Results:A totals of 80 patients (53 males and 27 females) their age range (38-76 years) with a mean of 53.3 ± 7.97, 31 out of the 80(38.8%) were smokers. The results show there was a significant correlation between the occurrence of retinal artery atherosclerosis and the severity of coronary artery disease (CAD) development with p=0.0001. Also when using the CAD severity (using modified Gensini scoring) as a dependent variable a significant association between it and retinal atherosclerosis scores by using the Scheie criteria, and hypertension, smoking, and left ventricular hypertrophy (LVH) was noticed. Conclusions:Retinal hypertensive changes at any grade can predict CAD severity in any hypertensive patients presenting with anginal chest pain with a moderate to high accuracy. Therefore retinopathy has a predictive and good association with CAD in patients with hypertension. Hence by assessing the retinal micro vascular changes could be used as an early cost effective method to screen and to predict CAD.

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Section: Discussionmentioning

confidence: 85%

Hypertensive Retinopathy can Predict Severity of Coronary Artery Disease in Hypertensive Patients Presenting with Angina

Asklany¹,

Mohamed²,

Genidy³

et al. 2018

J Hypertens

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“…(8) Previous studies have shown that some characteristics of retinal microvasculature are associated with strokes, which may be predicted by computational retinal analysis. (9)(10)(11)(12)(13)(14) Most studies have investigated only the risks or other aspects of strokes but the association between retinal parameters and the stroke side has not been demonstrated so far. In this study, retinal parameters were extracted from colour fundus retinal images and the retinal characteristics were used via a logistic model to explore the association further.…”

Section: Introductionmentioning

confidence: 99%

Stroke Occurring on the Left or Right Side of the Brain Can Be Identified by the Analysis of Retinal Images: A Case Control Study

Zhuo¹,

Lin²,

Wu³

et al. 2020

Preprint

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Background: The burden of stroke in China has increased dramatically in the past 30 years. Specifying the treatment according to the side of stroke in the brain might be an effective way to reduce the burden. Current imaging tools to identify the side of brain stroke, such as magnetic resonance imaging (MRI), are expensive and time-consuming. Hence, there is a great need for a rapid and inexpensive assessment. In this case, retinal image analysis is a possible approach for stroke side identification. This study aimed at determining the association between retinal characteristics and the stroke side and to establish a predictive model for further investigation.Methods: A total of 168 patients (89 left-sided stroke patients and 79 right-sided stroke patients) were recruited from the Shenzhen Traditional Chinese Medicine Hospital in the study. Retinal characteristics were analysed using an automated retinal image analysis (ARIA) system. Multivariable logistic regression was used to identify and develop predictive models.Results: Each unit increase in the right eye bifurcation coefficient of arterioles increased the risk of right-side stroke by 7.523 times (95% CI, 1.823–31.044). Additionally, an elevated bifurcation coefficient of venules in the right eye also increased the risk of stroke in the right side of the brain, with an odds ratio (OR) of 7.377 (95% CI, 1.771–30.724). A complex retinal composite score was also associated with a higher risk of right-side stroke (OR, 4.955; 95% CI, 3.061–8.022).Conclusions: This study demonstrated that retinal images can provide useful information for stroke side identification, and specific retinal characteristics may help predict the occurrence of stroke.Trial registration: Acupuncture Clinical Trail Redistry, ChiCTR1800019647, Registered 01 November 2018, AMCTR-OPC-18000228.

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“…A population-based study collaborating with Beaver Dam Eye Study (BDES) of [ 1 ] revealed that increased diameter ratio was associated with increased stroke mortality (P = 0.02 unadjusted). The paper [ 16 ] searched MEDLINE and EMBASE to find out the relation between microvascular changes of retinal microvasculature and prevalence or incident of stroke. In the study of [ 16 ] 20659 patients were involved, 1178 patients of them had stroke, and they found the Odd Ratio (OR) of stroke and retinal arteriolar narrowing and AV nicking was 1.42 and 1.91, respectively, which indicated that these abnormalities are slightly associated with stroke.…”

Section: Introductionmentioning

confidence: 99%

“…The paper [ 16 ] searched MEDLINE and EMBASE to find out the relation between microvascular changes of retinal microvasculature and prevalence or incident of stroke. In the study of [ 16 ] 20659 patients were involved, 1178 patients of them had stroke, and they found the Odd Ratio (OR) of stroke and retinal arteriolar narrowing and AV nicking was 1.42 and 1.91, respectively, which indicated that these abnormalities are slightly associated with stroke. Microvascular lesions like microaneurysm and haemorrhages which were found as highly associated with stroke as their OR were 3.83 and 3.21, respectively, and the OR between stroke and arteriole narrowing and venular network are 2.28 and 1.80 indicated the association of these abnormalities with stroke [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the study of [ 16 ] 20659 patients were involved, 1178 patients of them had stroke, and they found the Odd Ratio (OR) of stroke and retinal arteriolar narrowing and AV nicking was 1.42 and 1.91, respectively, which indicated that these abnormalities are slightly associated with stroke. Microvascular lesions like microaneurysm and haemorrhages which were found as highly associated with stroke as their OR were 3.83 and 3.21, respectively, and the OR between stroke and arteriole narrowing and venular network are 2.28 and 1.80 indicated the association of these abnormalities with stroke [ 16 ]. A cohort study of Asian Malay persons consisting of 3189 patients, free from prevalent stroke at baseline, revealed that 51 (1.93%) participants had an incident stroke event that could be predicted by analyzing the microvascular changes of retinal vasculature [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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A Review on the Extraction of Quantitative Retinal Microvascular Image Feature

Kipli

Hoque

Lim

et al. 2018

Computational and Mathematical Methods in Medicine

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Digital image processing is one of the most widely used computer vision technologies in biomedical engineering. In the present modern ophthalmological practice, biomarkers analysis through digital fundus image processing analysis greatly contributes to vision science. This further facilitates developments in medical imaging, enabling this robust technology to attain extensive scopes in biomedical engineering platform. Various diagnostic techniques are used to analyze retinal microvasculature image to enable geometric features measurements such as vessel tortuosity, branching angles, branching coefficient, vessel diameter, and fractal dimension. These extracted markers or characterized fundus digital image features provide insights and relates quantitative retinal vascular topography abnormalities to various pathologies such as diabetic retinopathy, macular degeneration, hypertensive retinopathy, transient ischemic attack, neovascular glaucoma, and cardiovascular diseases. Apart from that, this noninvasive research tool is automated, allowing it to be used in large-scale screening programs, and all are described in this present review paper. This paper will also review recent research on the image processing-based extraction techniques of the quantitative retinal microvascular feature. It mainly focuses on features associated with the early symptom of transient ischemic attack or sharp stroke.

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The association between retinal vasculature changes and stroke: a literature review and Meta-analysis

Abstract: Retinal vasculature changes have a specific relationship to stroke, which is promising evidence for the prediction of stroke using computerized retinal vessel analysis.

Cited by 23 publications

References 31 publications

Hypertensive Retinopathy can Predict Severity of Coronary Artery Disease in Hypertensive Patients Presenting with Angina

Hypertensive Retinopathy can Predict Severity of Coronary Artery Disease in Hypertensive Patients Presenting with Angina

Stroke Occurring on the Left or Right Side of the Brain Can Be Identified by the Analysis of Retinal Images: A Case Control Study

A Review on the Extraction of Quantitative Retinal Microvascular Image Feature

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