Association of Retinopathy and Retinal Microvascular Abnormalities With Stroke and Cerebrovascular Disease

Background and Purpose— Abnormalities of the retinal circulation may be associated with cerebrovascular disease. We investigated associations between retinal microvascular abnormalities and (1) strokes and subclinical cerebral infarcts and (2) cerebral white matter lesions in a UK-based triethnic population-based cohort. Methods— A total of 1185 participants (age, 68.8±6.1 years; 77% men) underwent retinal imaging and cerebral magnetic resonance imaging. Cerebral infarcts and white matter hyperintensities were identified on magnetic resonance imaging, retinopathy was graded, and retinal vessels were measured. Results— Higher retinopathy grade (odds ratio [OR], 1.40 [95% confidence interval (95% CI), 1.16–1.70]), narrower arteriolar diameter (OR, 0.98 [95% CI, 0.97–0.99]), fewer symmetrical arteriolar bifurcations (OR, 0.84 [95% CI, 0.75–0.95]), higher arteriolar optimality deviation (OR, 1.16 [95% CI, 1.00–1.34]), and more tortuous venules (OR, 1.20 [95% CI, 1.09–1.32]) were associated with strokes/infarcts and white matter hyperintensities. Associations with quantitative retinal microvascular measures were independent of retinopathy. Conclusions— Abnormalities of the retinal microvasculature are independently associated with stroke, cerebral infarcts, and white matter lesions.