title: Transient ischemic attack and acute ischemic stroke: associations with retinal microvascular signs.
abstract: OBJECTIVE
  Small vessel disease plays a role in cerebral events. We aimed to investigate the prevalence and patterns of retinal microvascular signs (surrogates for cerebral small vessel disease) among patients with transient ischemic attack (TIA) or acute stroke and population control subjects.
  
  
  METHODS
  Patients with TIA or acute stroke aged ≥49 years admitted to hospitals in Melbourne and Sydney, Australia, were recruited to the Multi-Centre Retina and Stroke Study (n=693, 2005 to 2007). Control subjects were Blue Mountains Eye Study participants aged ≥49 years without TIAs or stroke (n=3384, 1992 to 1994, west of Sydney). TIA, ischemic stroke, or primary intracerebral hemorrhage was classified using standardized neurological assessments, including neuroimaging. Retinal microvascular signs (retinopathy, focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar light reflex) were assessed from retinal photographs masked to clinical information.
  
  
  RESULTS
  Patients with TIA or acute stroke were older than control subjects and more likely to have stroke risk factors. After adjustment for study site and known risk factors, all retinal microvascular signs were more common in patients with TIA or acute stroke than in control subjects (OR, 1.9 to 8.7; P<0.001). Patients with TIA and those with ischemic stroke had similar prevalences of nondiabetic retinopathy (26.9% versus 29.5%; OR, 0.8; 95% CI, 0.5 to 1.6), diabetic retinopathy (55.5% versus 50.0%; OR, 1.3; 95% CI, 0.4 to 3.6), focal arteriolar narrowing (15.6% versus 18.4%; OR, 0.8; 95% CI, 0.4 to 1.5), and arteriovenous nicking (23.0% versus 17.8%; OR, 1.4; 95% CI, 0.7 to 2.7).
  
  
  CONCLUSIONS
  Patients with TIA and acute stroke may share similar risk factors or pathogenic mechanisms.
authors.affiliation: MMed, Centre for Vision Research, Westmead Millennium Institute, University of Sydney C24, NSW 2145, Australia. jiejin_wang@wmi.usyd.edu.au
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Baker
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hand
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.forename: Richard I
authors.initials: RI
authors.lastname: Lindley
authors.forename: Elena
authors.initials: E
authors.lastname: Rochtchina
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.forename: Gerald
authors.initials: G
authors.lastname: Liew
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000473:pathology*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D012164:Retinal Diseases / Q000209:etiology* / Q000473:pathology*; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000473:pathology*