title: Localized retinal nerve fiber layer defects and stroke.
abstract: OBJECTIVE
  Because the blood circulation system of retina and brain are closely related to each other, we examined whether stroke is associated with localized retinal nerve fiber layer defects (RNFLDs).
  
  
  METHODS
  Patients with acute ischemic stroke as part of a hospital-based study group were compared with the participants of the population-based group Beijing Eye Study. The retina was imaged by spectral-domain optical coherence tomography for the detection of localized RNFLDs.
  
  
  RESULTS
  The study included 154 patients with acute ischemic stroke and 2890 subjects from the Beijing Eye Study for whom optical coherence tomographic images of the retinal nerve fiber layer and data on a previous cerebral stroke were available. In logistic regression analysis, acute stroke was significantly associated with localized RNFLDs (P<0.001; odds ratio, 6.23; 95% confidence interval, 4.17-9.30) after adjusting for age, male sex, arterial hypertension, diabetes mellitus, and higher concentration of the C-reactive protein. In a similar manner, previous stroke was associated with localized RNFLDs (P=0.04; odds ratio, 1.48; 95% confidence interval, 1.02-2.16) in multivariate analysis. In a reverse manner, presence of localized RNFLDs was associated with cerebral stroke (P<0.001; odds ratio, 3.54; 95% confidence interval, 2.68-4.67) after adjusting for age, sex, and prevalence of diabetes mellitus.
  
  
  CONCLUSIONS
  Localized RNFLDs showed a strong association with previous or acute cerebrovascular stroke and vice versa after adjustment for other systemic and ocular factors. Localized RNFLDs that can be assessed by noninvasive optical coherence tomographic imaging may be added to the panoply of retinal morphological features of stroke.
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.).
authors.forename: Dandan
authors.initials: D
authors.lastname: Wang
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.).
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.).
authors.forename: Chunxue
authors.initials: C
authors.lastname: Wang
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.).
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.).
authors.forename: Qi Sheng
authors.initials: QS
authors.lastname: You
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.).
authors.forename: Ya Xing
authors.initials: YX
authors.lastname: Wang
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.).
authors.forename: Liang
authors.initials: L
authors.lastname: Zhao
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.). zxq@vip.163.com weiwenbintr@163.com.
authors.forename: Wen Bin
authors.initials: WB
authors.lastname: Wei
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.). zxq@vip.163.com weiwenbintr@163.com.
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: From the Department of Neurology, Beijing Tiantan Hospital (D.W., C.W., X.Z.), Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (Y.L., W.B.W.), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital (L.X., Q.S.Y., Y.X.W., L.Z., J.B.J.), Capital Medical University, Beijing, China; and Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany (J.B.J.).
authors.forename: Jost B
authors.initials: JB
authors.lastname: Jonas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D048909:Diabetes Complications / Q000097:blood / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology*; D055351:Retinal Neurons / Q000473:pathology*; D012737:Sex Factors; D020521:Stroke / Q000097:blood / Q000150:complications* / Q000473:pathology*; D041623:Tomography, Optical Coherence
chemical_list: D002097:C-Reactive Protein
keywords: stroke; tomography, optical coherence