Microvascular lesions in the brain and retina: The age, gene/environment susceptibility-Reykjavik study.
OBJECTIVE
To investigate whether the severity and location of cerebral white matter hyperintensities (WMHs) and brain infarcts are correlated with the signs of retinal microvascular abnormalities in the elderly.


METHODS
The study included 4,176 men and women (mean age, 76 years) who participated in the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study. Digital retinal images of both dilated eyes were taken and evaluated for the presence of retinal focal arteriolar signs (focal arteriolar narrowing and arteriovenous nicking) and retinopathy lesions (retinal blot hemorrhages and microaneurysms). Brain magnetic resonance imaging scans were acquired and evaluated for the presence and distribution of cerebral infarcts and WMHs. Logistic and multinomial logistic models were constructed to estimate the association of retinal microvascular signs to brain lesions.


RESULTS
Controlling for demographic and major cardiovascular risk factors, we found that retinal focal arteriolar signs, but not retinopathy lesions, were significantly associated with an increasing load of subcortical and periventricular WMHs. The strongest association was found between retinal arteriolar signs and a heavier WMH load, specifically in the subcortical frontal lobe, and periventricular frontal and parietal caps. There was a tendency toward bilateral retinal focal arteriolar narrowing being more strongly associated with the heavier load of subcortical WMHs. Arteriovenous nicking was significantly associated with subcortical infarcts.


CONCLUSIONS
In older adults, retinal focal arteriolar signs, but not retinopathy lesions, are correlated with the load of diffuse WMHs, particularly those located in the subcortical frontal lobe, and the periventricular frontal and parietal caps of the brain.
Qiu
Chengxuan
C
Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, 7201 Wisconsin Avenue, Bethesda, MD 20892, USA.
Cotch
Mary Frances
MF
Sigurdsson
Sigurdur
S
Klein
Ronald
R
Jonasson
Fridbert
F
Klein
Barbara E K
BE
Garcia
Melissa
M
Jonsson
Palmi V
PV
Harris
Tamara B
TB
Eiriksdottir
Gudny
G
Kjartansson
Olafur
O
van Buchem
Mark A
MA
Gudnason
Vilmundur
V
Launer
Lenore J
LJ
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001927:Brain Diseases / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D016009:Chi-Square Distribution; D004198:Disease Susceptibility / Q000473:pathology; D004777:Environment; D005260:Female; D006801:Humans; D007055:Iceland / Q000208:ethnology; D007091:Image Processing, Computer-Assisted; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D055806:Microvessels / Q000293:injuries / Q000473:pathology*; D012164:Retinal Diseases / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors