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Differing associations of white matter lesions and lacunar infarction with retinal microvascular signs.

Publication ,  Journal Article
Liew, G; Baker, ML; Wong, TY; Hand, PJ; Wang, JJ; Mitchell, P; De Silva, DA; Wong, M-C; Rochtchina, E; Lindley, RI; Wardlaw, JM; Hankey, GJ ...
Published in: Int J Stroke
October 2014

BACKGROUND: White matter lesions (WML) and lacunar infarcts (LI) are believed to have microvascular etiologies but the exact microvascular changes occurring in each is unclear. AIM: Using the retina as a proxy, we assessed retinal microvascular changes in WML and LI. METHODS: We prospectively recruited 1211 acute stroke patients. Four subgroups were identified from neuroimaging: WML alone, LI alone, both WML and LI, neither WML nor LI. Masked retinal photographs identified retinopathy and retinal arteriolar wall signs and measured retinal vascular caliber. RESULTS: Compared with 448 controls with neither WML nor LI, 384 patients with only WML were more likely to have retinopathy [odds ratio (OR) 1·5, 95% confidence interval (CI) 1·1 to 2·1] and enhanced arteriolar light reflex (OR 1·6, 95% CI 1·1 to 2·3); 200 patients with only LI were more likely to have arteriolar narrowing (OR 1·6, 95% CI 1·1 to 2·3) and enhanced arteriolar light reflex (OR 1·6, 95% CI 1·0 to 2·4); and 179 patients with both WML and LI were more likely to have arteriovenous nicking (OR 1·7, 95% CI 1·1 to 2·6), enhanced arteriolar light reflex (OR 2·0, 95% CI 1·3 to 3·2) and wider venules (OR 2·3, 95% CI 1·4 to 3·6). All analyses were adjusted for age, gender, study site and cardiovascular risk factors. CONCLUSION: Both WML and LI were associated with retinal microvascular signs, supporting a microvascular etiology. Differing patterns of association suggest different mechanisms may predominate, e.g. greater endothelial permeability in WML, and ischemia associated with arteriolar wall disease in LI.

Duke Scholars

Published In

Int J Stroke

DOI

EISSN

1747-4949

Publication Date

October 2014

Volume

9

Issue

7

Start / End Page

921 / 925

Location

United States

Related Subject Headings

  • Young Adult
  • White Matter
  • Stroke, Lacunar
  • Retinal Vessels
  • Prospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Microvessels
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Liew, G., Baker, M. L., Wong, T. Y., Hand, P. J., Wang, J. J., Mitchell, P., … Multi-Centre Retinal Stroke Study Group. (2014). Differing associations of white matter lesions and lacunar infarction with retinal microvascular signs. Int J Stroke, 9(7), 921–925. https://doi.org/10.1111/j.1747-4949.2012.00865.x
Liew, Gerald, Michelle L. Baker, Tien Y. Wong, Peter J. Hand, Jie Jin Wang, Paul Mitchell, Deidre A. De Silva, et al. “Differing associations of white matter lesions and lacunar infarction with retinal microvascular signs.Int J Stroke 9, no. 7 (October 2014): 921–25. https://doi.org/10.1111/j.1747-4949.2012.00865.x.
Liew G, Baker ML, Wong TY, Hand PJ, Wang JJ, Mitchell P, et al. Differing associations of white matter lesions and lacunar infarction with retinal microvascular signs. Int J Stroke. 2014 Oct;9(7):921–5.
Liew, Gerald, et al. “Differing associations of white matter lesions and lacunar infarction with retinal microvascular signs.Int J Stroke, vol. 9, no. 7, Oct. 2014, pp. 921–25. Pubmed, doi:10.1111/j.1747-4949.2012.00865.x.
Liew G, Baker ML, Wong TY, Hand PJ, Wang JJ, Mitchell P, De Silva DA, Wong M-C, Rochtchina E, Lindley RI, Wardlaw JM, Hankey GJ, Multi-Centre Retinal Stroke Study Group. Differing associations of white matter lesions and lacunar infarction with retinal microvascular signs. Int J Stroke. 2014 Oct;9(7):921–925.
Journal cover image

Published In

Int J Stroke

DOI

EISSN

1747-4949

Publication Date

October 2014

Volume

9

Issue

7

Start / End Page

921 / 925

Location

United States

Related Subject Headings

  • Young Adult
  • White Matter
  • Stroke, Lacunar
  • Retinal Vessels
  • Prospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Microvessels
  • Male
  • Humans