Retinal microvascular changes and MRI signs of cerebral atrophy in healthy, middle-aged people.
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.
D000375:Aging / Q000473:pathology; D001160:Arterioles / Q000648:ultrastructure; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010781:Photography; D015203:Reproducibility of Results; D012166:Retinal Hemorrhage / Q000453:epidemiology; D012171:Retinal Vessels / Q000648:ultrastructure*; D012307:Risk Factors; D014699:Venules / Q000648:ultrastructure