title: Telemedical assessment of optic nerve head and retina in patients after recent minor stroke or TIA.
abstract: The aim of the study is to telemedically assess the prevalence of simple optic nerve atrophy and retinal arteriolar anomalies in subjects who have had a minor stroke or TIA within 14 days, and to compare these results with an age-matched control group. By using a mobile examination unit, retinal photographs were taken with a 45° non-mydriatic colour fundus camera (KOWA NM-45, non-mydriatic-alpha) in patients who had suffered from a minor stroke or TIA within 14 days of the time of the examination. Retinal photographs were focused on the optic nerve head region. Pupils were not dilated. The documented medical history and the retinal images were stored on a server using browser independent web-based software running on PCs, tablets and smartphones. After completing the upload of the medical interview and the retinal images into the electronic patient chart, all retinal images were evaluated via telemedicine by an experienced senior consultant ophthalmologist. Age-matched normotensive, non-diabetic subjects (aged 40-89 years) who reported no systemic or ocular diseases were used as the control group. Both study groups were divided into five decades of life (40-49; 50-59; 60-69; 70-79; 80-89 years). We calculated the prevalences and the ratios of prevalences of optic nerve atrophy and retinal arteriolar anomalies between the stroke and the control group per decades of life. 139 minor stroke or TIA subjects (aged 40-89 years) and 1611 age-matched control subjects were examined. In the stroke group, we found significantly increased prevalences of optic nerve atrophy and retinal arteriolar anomalies throughout the 5th-8th decade of life when compared to age-matched controls. The prevalence of optic nerve atrophy in stroke subjects outranged the prevalence in the controls depending on age-class by a factor of 3-21. Simple optic nerve atrophy is frequent in patients who have suffered from an ischemic stroke or TIA, and it seems to indicate vascular damage, indicating the necessity for telemedically assisted assessment of the optic nerve.
authors.affiliation: Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany. JohannesWolz@gmx.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Wolz
authors.affiliation: Department of Neurology, Centre for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Audebert
authors.affiliation: Department of Neurology, Centre for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Inga
authors.initials: I
authors.lastname: Laumeier
authors.affiliation: Department of Neurology, Centre for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ahmadi
authors.affiliation: Department of Neurology, Centre for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Maureen
authors.initials: M
authors.lastname: Steinicke
authors.affiliation: Department of Neurology, Centre for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Caroline
authors.initials: C
authors.lastname: Ferse
authors.affiliation: Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.|Interdisciplinary Centre of Ophthalmic Preventive Medicine and Imaging, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Michelson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles / Q000000981:diagnostic imaging / Q000473:pathology; D001284:Atrophy / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012164:Retinal Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D012171:Retinal Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D020521:Stroke / Q000150:complications*; D017216:Telemedicine / Q000379:methods*
keywords: Hypertensive retinopathy; Retinal arteriolar anomalies; Simple optic nerve atrophy; Stroke