Epidemiological evaluation of funduscopic findings in cerebrovascular diseases. II. A multivariate analysis of funduscopic findings.
The interrelationship of the funduscopic, physical and laboratory findings, the additional information of each funduscopic finding when physical and laboratory findings were considered simultaneously, and the relative importance of each retinal finding in the funduscopic pictures were investigated by a series of multivariate analysis for 68 cerebral hemorrhage, 47 cerebral thrombosis and 230 controls in two rural towns, Akabane and Asahi, in Japan and the results were as follows: 1. For the occurrence of cerebral hemorrhage, narrowing of arteriole and irregular constriction were especially important indicators, and retinal bleeding and lateral displacement were also valuable but less than narrowing and irregular constriction. On the other hand, for the occurrence of cerebral thrombosis, arteriolar reflex was considered as the most valuable indicator, and irregular constriction, lateral displacement and white plaque were also important but less than arteriolar reflex. 2. Narrowing of arteriole was most highly related with irregular constriction while the correlation between retinal bleeding and white plaque, and also the correlation between arteriolar reflex, vertical and lateral displacement and tapering were significant. 3. A significiant correlation among physical and laboratory findings was found only between systolic and diastolic blood pressure as far as analysed. Funduscopic findings by Scheie's hypertensive and Keith-Wagener's classifications were highly correlated with systolic and diastolic blood pressure. 4. Narrowing and irregular constriction were significantly correlated with systolic and diastolic blood pressure, and the relation between retinal bleeding and glycosuria was significant. 5. An analysis of the additional information of each funduscopic finding, when evaluated with the physical and laboratory findings simultaneously, revealed that irregular constriction, lateral displacement and narrowing gave prominent additional information for the occurrence of cerebral hemorrhage, while arteriolar reflex, lateral and vertical displacement and white plaque gave valuable information for the occurrence of cerebral thrombosis. 6. It is noteworthy from these multivariate analyses that narrowing and irregular constriction may arise from a similar pathophysiological mechanism which brings out vasoconstriction and the resultant organic changes due to hypertension. It is also noticed that arteriolar reflex and A/V crossing phenomenon may come from the different pathophysiological mechanism related to arteriosclerosis. It was stressed that detailed analyses of observer variability and evolution of funduscopic findings would be necessary.
D000419:Albuminuria / Q000150:complications / Q000503:physiopathology; D000704:Analysis of Variance; D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D005654:Fundus Oculi; D006029:Glycosuria / Q000150:complications / Q000503:physiopathology; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D007564:Japan; D012161:Retinal Artery / Q000503:physiopathology; D012166:Retinal Hemorrhage / Q000150:complications / Q000503:physiopathology