RT Journal Article
SR Electronic
T1 Retinal microvascular signs and recurrent vascular events in patients with TIA or minor stroke
JF Stroke and Vascular Neurology
JO Stroke Vasc Neurol
FD BMJ Publishing Group Ltd
SP 379
OP 386
DO 10.1136/svn-2022-001784
VO 8
IS 5
A1 Klyscz, Philipp
A1 Ihl, Thomas
A1 Laumeier, Inga
A1 Steinicke, Maureen
A1 Endres, Matthias
A1 Michelson, Georg
A1 Audebert, Heinrich J
YR 2023
UL http://svn.bmj.com/content/8/5/379.abstract
AB Background and purpose Retinal pathologies are an independent risk factor for ischaemic stroke, but research on the predictive value of retinal abnormalities for recurrent vascular events in patients with prior stroke is inconclusive. We investigated the association of retinal pathologies with subsequent vascular events.Methods In a substudy of the Intensified secondary prevention intending a reduction of recurrent events in TIA and minor stroke patients (INSPiRE-TMS) trial, we enrolled patients with recent transient ischaemic attack (TIA) or minor stroke with at least one modifiable risk factor. Primary outcome was the composite of subsequent vascular events. Retinal photographs were taken at baseline and categorised into three different fundus groups by a telemedically linked ophthalmologist.Results 722 patients participated in the current study and 109 major vascular events occurred. After multivariable adjustments, we did not find a significant association between fundus categories and risk for subsequent vascular events (HRs for moderate vascular retinopathy and vascular retinopathy with vessel rarefaction in comparison to no vascular retinopathy 1.03 (95% CI 0.64 to 1.67), p=0.905 and 1.17 (95% CI 0.62 to 2.20), p=0.626). In a selective post hoc analysis in patients with diabetes mellitus and hypertension, patients with vascular retinopathy with vessel rarefaction had a higher risk for recurrent stroke (HR 24.14 (95% CI 2.74 to 212.50), p=0.004).Conclusions Retinal changes did not predict major subsequent vascular events in patients with recent TIA or minor stroke. Further studies are needed to examine the utility of fundus photography in assessing the risk of stroke recurrence in patients with diabetes mellitus and hypertension.Data are available on reasonable request. The data supporting the findings in the present study are available from the principal investigator (heinrich.audebert@charite.de) on reasonable request.