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Retinal microvascular changes and risk of stroke: the Singapore Malay Eye Study.

Publication ,  Journal Article
Cheung, CY-L; Tay, WT; Ikram, MK; Ong, YT; De Silva, DA; Chow, KY; Wong, TY
Published in: Stroke
September 2013

BACKGROUND AND PURPOSE: To examine the relationship between retinal microvascular measures and incident stroke in an Asian Malay population. METHODS: We conducted a prospective, population-based cohort study of Asian Malay persons 40 to 80 years at baseline. Retinal microvascular signs were assessed from baseline retinal photographs including quantitative retinal microvascular parameters (caliber, branching angle, tortuosity, and fractal dimension) and qualitative retinopathy signs. Incident stroke cases were identified during the follow-up period. Cox proportional-hazards regression and incremental usefulness analysis (calibration, discrimination, and reclassification) were performed. RESULTS: A total of 3189 participants were free of prevalent stroke at baseline. During the follow-up (median, 4.41 years), 51 (1.93%) participants had an incident stroke event. In Cox proportional-hazards models adjusting for established stroke predictors (age, sex, systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, smoking, glycosylated hemoglobin, and antihypertensive medication), retinopathy (hazard ratio, 1.94; 95% confidence interval, 1.01-3.72) and larger retinal venular caliber (hazard ratio, 3.28; 95% confidence interval, 1.30-8.26, comparing fourth versus first quartiles) were associated with risk of stroke. Compared with the model with only established risk factors, the addition of retinal measures improved the prediction of stroke (C-Statistic 0.826 versus 0.792; P=0.017) and correctly reclassified 5.9% of participants with incident stroke and 3.4% of participants with no incident stroke. CONCLUSIONS: Retinal microvascular changes are related to an increased risk of stroke in Asian Malay, consistent with data from white populations. Retinal imaging improves the discrimination and stratification of stroke risk beyond that of established risk factors by a significant but small margin.

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Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

September 2013

Volume

44

Issue

9

Start / End Page

2402 / 2408

Location

United States

Related Subject Headings

  • Stroke
  • Singapore
  • Risk Factors
  • Retinal Vessels
  • Retinal Diseases
  • Prospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Microvessels
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cheung, C.-L., Tay, W. T., Ikram, M. K., Ong, Y. T., De Silva, D. A., Chow, K. Y., & Wong, T. Y. (2013). Retinal microvascular changes and risk of stroke: the Singapore Malay Eye Study. Stroke, 44(9), 2402–2408. https://doi.org/10.1161/STROKEAHA.113.001738
Cheung, Carol Yim-lui, Wan Ting Tay, M Kamran Ikram, Yi Ting Ong, Deidre A. De Silva, Khuan Yew Chow, and Tien Yin Wong. “Retinal microvascular changes and risk of stroke: the Singapore Malay Eye Study.Stroke 44, no. 9 (September 2013): 2402–8. https://doi.org/10.1161/STROKEAHA.113.001738.
Cheung CY-L, Tay WT, Ikram MK, Ong YT, De Silva DA, Chow KY, et al. Retinal microvascular changes and risk of stroke: the Singapore Malay Eye Study. Stroke. 2013 Sep;44(9):2402–8.
Cheung, Carol Yim-lui, et al. “Retinal microvascular changes and risk of stroke: the Singapore Malay Eye Study.Stroke, vol. 44, no. 9, Sept. 2013, pp. 2402–08. Pubmed, doi:10.1161/STROKEAHA.113.001738.
Cheung CY-L, Tay WT, Ikram MK, Ong YT, De Silva DA, Chow KY, Wong TY. Retinal microvascular changes and risk of stroke: the Singapore Malay Eye Study. Stroke. 2013 Sep;44(9):2402–2408.

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

September 2013

Volume

44

Issue

9

Start / End Page

2402 / 2408

Location

United States

Related Subject Headings

  • Stroke
  • Singapore
  • Risk Factors
  • Retinal Vessels
  • Retinal Diseases
  • Prospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Microvessels
  • Male