Retinal microvascular signs may provide clues to the underlying vasculopathy in patients with deep intracerebral hemorrhage.
OBJECTIVE
Deep intracerebral hemorrhage (ICH) and lacunar infarcts are the result of small vessel disease, whereas nonlacunar infarcts are often caused by large artery atherosclerosis or cardiac embolism. We hypothesized that patients with deep ICH and lacunar infarcts have similar retinal microvascular signs and that these differ from those seen in patients with nonlacunar infarcts.


METHODS
We studied patients with acute stroke and classified their stroke as deep ICH, lacunar infarction, or nonlacunar infarction. In a masked fashion we assessed retinal photographs for quantitative and qualitative evidence of microvascular damage.


RESULTS
We recruited 630 patients (51 had deep ICH, 93 had lacunar infarction, and 486 had nonlacunar infarction). Patients with deep ICH were more likely than those with nonlacunar infarcts to have severe focal narrowing of the retinal arterioles (OR, 3.7), severe arteriovenous nicking (OR, 2.6), and quantitatively narrower retinal arterioles and wider retinal venules. Retinal microvascular signs were similar in patients with deep ICH and lacunar infarction.


CONCLUSIONS
Patients with deep ICH and lacunar infarcts are more likely than patients with nonlacunar infarcts to have signs indicating hypertensive damage in the retinal arteriolar wall.
Baker
Michelle L
ML
Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
Hand
Peter J
PJ
Liew
Gerald
G
Wong
Tien Y
TY
Rochtchina
Elena
E
Mitchell
Paul
P
Lindley
Richard I
RI
Hankey
Graeme J
GJ
Wang
Jie Jin
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000209:etiology / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000473:pathology; D008297:Male; D055806:Microvessels / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D012171:Retinal Vessels / Q000473:pathology* / Q000503:physiopathology; D020521:Stroke / Q000209:etiology / Q000473:pathology; D014652:Vascular Diseases / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000473:pathology*