title: Retinopathy as an indicator of silent brain infarction in asymptomatic hypertensive subjects.
abstract: OBJECTIVE
  Silent brain infarction (SBI), which is cerebral target organ damage of hypertensive microangiopathies, is frequently seen in hypertensive patients. The purpose of this study is to investigate the relation between hypertensive retinopathy (HTR) and SBI in subjects without a history of stroke or transient ischemic attack.
  
  
  METHODS
  Five hundred-fifty hypertensive subjects without history of stroke or transient ischemic attack had brain MRI and retinal photographs taken. The presence of SBI was assessed from the MRI scans, which was defined as a lesion of at least 3 mm in diameter with typical imaging characteristics. The presence HTR was defined from digitized retinal photographs.
  
  
  RESULTS
  Seventy-seven subjects (14%) showed HTR (grade 1 in 46, grade 2 in 31 persons). A multivariate analysis showed that age (OR, 1.07; 95% CI, 1.03 to 1.10) and HTR (OR, 2.01 for grade 1; OR, 3.03 for grade 2) were the independent indicators for the presence of SBI. The higher the grade of HTR, the more prevalent SBI than persons with normal retina (by linear by linear association test, p=0.001).
  
  
  CONCLUSIONS
  HTR is associated with the presence of SBI. This finding suggests that retinal photography may be useful for identifying hypertensive subjects at increased risk of having SBI regardless of current blood pressure status.
authors.affiliation: Department of Neurology, Kyunghee University East-West Neo Medical Center, Seoul, Republic of Korea.
authors.forename: Hyung-Min
authors.initials: HM
authors.lastname: Kwon
authors.forename: Beom Joon
authors.initials: BJ
authors.lastname: Kim
authors.forename: Joo Youn
authors.initials: JY
authors.lastname: Oh
authors.forename: Sang Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Seung-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Byung-Hee
authors.initials: BH
authors.lastname: Oh
authors.forename: Byung-Woo
authors.initials: BW
authors.lastname: Yoon
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012161:Retinal Artery / Q000473:pathology*; D012164:Retinal Diseases / Q000453:epidemiology / Q000473:pathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology / Q000473:pathology*