The association between retinal vasculature changes and stroke: a literature review and Meta-analysis.
OBJECTIVE
To determine the association between retinal vasculature changes and stroke.


METHODS
MEDLINE and EMBASE were searched for relevant human studies to September 2015 that investigated the association between retinal vasculature changes and the prevalence or incidence of stroke; the studies were independently examined for their qualities. Data on clinical characteristics and calculated summary odds ratios (ORs) were extracted for associations between retinal microvascular abnormalities and stroke, including stroke subtypes where possible, and adjusted for key variables.


RESULTS
Nine cases were included in the study comprising 20 659 patients, 1178 of whom were stroke patients. The retinal microvascular morphological markers used were hemorrhage, microaneurysm, vessel caliber, arteriovenous nicking, and fractal dimension. OR of retinal arteriole narrowing and retinal arteriovenous nicking and stroke was 1.42 and 1.91, respectively, indicating that a small-caliber retinal arteriole and retinal arteriovenous nicking were associated with stroke. OR of retinal hemorrhage and retinal microaneurysm and stroke was 3.21 and 3.83, respectively, indicating that retinal microvascular lesions were highly associated with stroke. Results also showed that retinal fractal dimension reduction was associated with stroke (OR: 2.28 for arteriole network, OR: 1.80 for venular network).


CONCLUSIONS
Retinal vasculature changes have a specific relationship to stroke, which is promising evidence for the prediction of stroke using computerized retinal vessel analysis.
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China; Nantong University Division of Cooperative Research Center on Evidence-based Medicine by Ministry of Education in China, Nantong 226001, Jiangsu Province, China.
Hui-Qun
HQ
Wu
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China; Nantong University Division of Cooperative Research Center on Evidence-based Medicine by Ministry of Education in China, Nantong 226001, Jiangsu Province, China.
Huan
H
Wu
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China; Nantong University Division of Cooperative Research Center on Evidence-based Medicine by Ministry of Education in China, Nantong 226001, Jiangsu Province, China.
Li-Li
LL
Shi
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China; Nantong University Division of Cooperative Research Center on Evidence-based Medicine by Ministry of Education in China, Nantong 226001, Jiangsu Province, China.
Li-Yuan
LY
Yu
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China; Nantong University Division of Cooperative Research Center on Evidence-based Medicine by Ministry of Education in China, Nantong 226001, Jiangsu Province, China.
Li-Yuan
LY
Wang
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China; Nantong University Division of Cooperative Research Center on Evidence-based Medicine by Ministry of Education in China, Nantong 226001, Jiangsu Province, China.
Ya-Lan
YL
Chen
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China; Nantong University Division of Cooperative Research Center on Evidence-based Medicine by Ministry of Education in China, Nantong 226001, Jiangsu Province, China.
Jin-Song
JS
Geng
Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China.
Jian
J
Shi
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China; Nantong University Division of Cooperative Research Center on Evidence-based Medicine by Ministry of Education in China, Nantong 226001, Jiangsu Province, China.
Kui
K
Jiang
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China; Nantong University Division of Cooperative Research Center on Evidence-based Medicine by Ministry of Education in China, Nantong 226001, Jiangsu Province, China.
Jian-Cheng
JC
Dong
Meta-analysis; retinal image; stroke; vasculature