HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Data Supplement Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wong, T. Y. Articles by Hubbard, L. D. Search for Related Content PubMed PubMed Citation Articles by Wong, T. Y. Articles by Hubbard, L. D. Related Collections MRI Volumetric MRI Retina All Neuropsychology/Behavior Neuropsychological assessment All Cognitive Disorders/Dementia Vascular dementia

Retinal microvascular changes and MRI signs of cerebral atrophy in healthy, middle-aged people

From the Singapore National Eye Center and National University of Singapore (Dr. Wong); Department of Ophthalmology, University of Melbourne (Dr. Wong); Department of Ophthalmology (Drs. Wong, R. Klein, and B.E.K. Klein, and L.D. Hubbard), University of Wisconsin, Madison; Department of Medicine (Dr. Mosley), University of Mississippi Medical Center, Jackson; Department of Epidemiology (Dr. Sharrett), Johns Hopkins University, Baltimore, MD; and Department of Biostatistics (Dr. Couper), University of North Carolina, Chapel Hill.

Address correspondence and reprint requests to Dr. T.Y. Wong, Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, East Melbourne 3002, Australia; e-mail: ophwty{at}nus.edu.sg

Objective: To examine the relation of retinal microvascular abnormalities and MRI signs of cerebral atrophy in healthy middle-aged people.

Methods: A population-based, cross-sectional study involved 1,684 persons aged 51 to 72 years who had cerebral MRI and retinal photography in 1993 to 1995. Sulcal and ventricular size were quantified from the MRI scans and coded as grades 0 to 9, with sulcal widening (SW) and ventricular enlargement (VE) defined as grades 3 or higher. The presence or absence of retinopathy, microaneurysms, hemorrhages, and other characteristics were defined from retinal photographs using a standardized protocol. Generalized arteriolar narrowing was defined from a computer-assisted measurement of arteriolar diameters from digitized photographs.

Results: Persons with retinopathy had higher sulcal (p = 0.001) and ventricular (p = 0.03) grades than persons without retinopathy. After adjusting for age, gender, race, mean arterial blood pressure, diabetes, cigarette smoking, common carotid artery intima–media thickness, and other vascular risk factors, retinopathy was significantly associated with SW (odds ratio [OR], 1.9; 95% CI, 1.2, 3.0) and VE (OR, 1.5; 95% CI, 1.0, 2.3). These associations persisted even in people without diabetes or hypertension (OR 1.9, 95% CI, 0.8, 4.4 for SW; OR 2.7, 95% CI, 1.2, 6.5 for VE). Other retinal arteriolar characteristics (arteriovenous nicking, focal and generalized arteriolar narrowing) were not related to sulcal or ventricular grade.

Conclusions: In healthy, middle-aged people, retinopathy is independently associated with sulcal and ventricular enlargement on MRI. This finding is compatible with the hypothesis that microvascular characteristics may influence the development of cerebral atrophic changes.

This article has been cited by other articles:

				T. T. Nguyen, J. J. Wang, and T. Y. Wong Retinal Vascular Changes in Pre-Diabetes and Prehypertension: New findings and their research and clinical implications Diabetes Care, October 1, 2007; 30(10): 2708 - 2715. [Full Text] [PDF]

				M. L. Baker, E. K. Marino Larsen, L. H. Kuller, R. Klein, B. E.K. Klein, D. S. Siscovick, C. Bernick, T. A. Manolio, and T. Y. Wong Retinal Microvascular Signs, Cognitive Function, and Dementia in Older Persons: The Cardiovascular Health Study Stroke, July 1, 2007; 38(7): 2041 - 2047. [Abstract] [Full Text] [PDF]

				N. Patton, A. Pattie, T. MacGillivray, T. Aslam, B. Dhillon, A. Gow, J. M. Starr, L. J. Whalley, and I. J. Deary The Association between Retinal Vascular Network Geometry and Cognitive Ability in an Elderly Population Invest. Ophthalmol. Vis. Sci., May 1, 2007; 48(5): 1995 - 2000. [Abstract] [Full Text] [PDF]

				C. Sun, G. Tikellis, R. Klein, D. C. Steffens, E. K. M. Larsen, D. S. Siscovick, B. E. K. Klein, and T. Y. Wong Are Microvascular Abnormalities in the Retina Associated With Depression Symptoms? The Cardiovascular Health Study Am J Geriatr Psychiatry, April 1, 2007; 15(4): 335 - 343. [Abstract] [Full Text] [PDF]

				D. S. Knopman, T. H. Mosley, D. J. Catellier, A. R. Sharrett, and for the Atherosclerosis Risk in Communities (ARIC) Cardiovascular risk factors and cerebral atrophy in a middle-aged cohort Neurology, September 27, 2005; 65(6): 876 - 881. [Abstract] [Full Text] [PDF]

				T. Y. Wong and R. McIntosh Hypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality Br. Med. Bull., September 7, 2005; 73-74(1): 57 - 70. [Abstract] [Full Text] [PDF]

				T. H. Mosley Jr, D. S. Knopman, D. J. Catellier, N. Bryan, R. G. Hutchinson, C. A. Grothues, A. R. Folsom, L. S. Cooper, G. L. Burke, D. Liao, et al. Cerebral MRI findings and cognitive functioning: The Atherosclerosis Risk in Communities Study Neurology, June 28, 2005; 64(12): 2056 - 2062. [Abstract] [Full Text] [PDF]

				T. Y. Wong and P. Mitchell Hypertensive Retinopathy N. Engl. J. Med., November 25, 2004; 351(22): 2310 - 2317. [Full Text] [PDF]