title: Is diabetic retinopathy an independent risk factor for ischemic stroke?
abstract: OBJECTIVE
  The relationship between diabetic retinopathy and ischemic stroke is uncertain and examined in this study.
  
  
  METHODS
  A population-based, prospective cohort study of 1617 middle-aged persons with diabetes. Diabetic retinopathy signs were ascertained from retinal photographs, and incident ischemic stroke events were prospectively identified and validated.
  
  
  RESULTS
  Over an average follow-up of 7.8 years, there were 75 ischemic stroke events. After adjustment for age, gender, race, center, 6-year mean arterial blood pressure, anti-hypertensive treatment use, fasting glucose, insulin treatment, duration of diabetes, high-density lipoprotein and low-density lipoprotein cholesterol levels and cigarette smoking status, diabetic retinopathy was associated with an increased risk of ischemic stroke (hazard rate ratio, 2.34; 95% CI, 1.13 to 4.86).
  
  
  CONCLUSIONS
  Diabetic retinopathy predicts incident ischemic stroke in people with diabetes, independent of other risk factors.
authors.affiliation: Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, Victoria 3002, Australia.
authors.forename: Ning
authors.initials: N
authors.lastname: Cheung
authors.forename: Sophie
authors.initials: S
authors.lastname: Rogers
authors.forename: David J
authors.initials: DJ
authors.lastname: Couper
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: A Richey
authors.initials: AR
authors.lastname: Sharrett
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D002545:Brain Ischemia / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D003930:Diabetic Retinopathy / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology