Prediction of incident stroke events based on retinal vessel caliber: a systematic review and individual-participant meta-analysis.

Journal Article (Journal Article;Review;Systematic Review)

The caliber of the retinal vessels has been shown to be associated with stroke events. However, the consistency and magnitude of association, and the changes in predicted risk independent of traditional risk factors, are unclear. To determine the association between retinal vessel caliber and the risk of stroke events, the investigators combined individual data from 20,798 people, who were free of stroke at baseline, in 6 cohort studies identified from a search of the Medline (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier B.V., Amsterdam, the Netherlands) databases. During follow-up of 5-12 years, 945 (4.5%) incident stroke events were recorded. Wider retinal venular caliber predicted stroke (pooled hazard ratio = 1.15, 95% confidence interval: 1.05, 1.25 per 20-micron increase in caliber), but the caliber of retinal arterioles was not associated with stroke (pooled hazard ratio = 1.00, 95% confidence interval: 0.92, 1.08). There was weak evidence of heterogeneity in the hazard ratio for retinal venular caliber, which may be attributable to differences in follow-up strategies across studies. Inclusion of retinal venular caliber in prediction models containing traditional stroke risk factors reassigned 10.1% of people at intermediate risk into different, mostly lower, risk categories.

Full Text

Duke Authors

Cited Authors

  • McGeechan, K; Liew, G; Macaskill, P; Irwig, L; Klein, R; Klein, BEK; Wang, JJ; Mitchell, P; Vingerling, JR; de Jong, PTVM; Witteman, JCM; Breteler, MMB; Shaw, J; Zimmet, P; Wong, TY

Published Date

  • December 1, 2009

Published In

Volume / Issue

  • 170 / 11

Start / End Page

  • 1323 - 1332

PubMed ID

  • 19884126

Pubmed Central ID

  • PMC2800263

Electronic International Standard Serial Number (EISSN)

  • 1476-6256

Digital Object Identifier (DOI)

  • 10.1093/aje/kwp306


  • eng

Conference Location

  • United States