A close look at your eyes may reveal your risk of a
Retina shows status of blood vessels in the brain by
non-invasive retinal imaging
13, 2013 - In a study reported in the American Heart Association journal
Hypertension, researchers said retinal imaging may someday help
assess if you're more likely to develop a stroke — the nation's No. 4
killer and a leading cause of disability.
"The retina provides information on the status of
blood vessels in the brain," said Mohammad Kamran Ikram, M.D., Ph.D.,
lead author of the study and assistant professor in the Singapore Eye
Research Institute, the Department of Ophthalmology and Memory Aging &
Cognition Centre, at the National University of Singapore.
imaging is a non-invasive and cheap way of examining the blood
vessels of the retina."
Worldwide, high blood pressure is the single most
important risk factor for stroke. However, it's still not possible to
predict which high blood pressure patients are most likely to develop a
Researchers tracked stroke occurrence for an
average 13 years in 2,907 patients with high blood pressure who had not
previously experienced a stroke. At baseline, each had photographs taken
of the retina, the light-sensitive layer of cells at the back of the
eyeball. Damage to the retinal blood vessels attributed to hypertension
— called hypertensive retinopathy — evident on the photographs was
scored as none, mild or moderate/severe.
During the follow-up, 146 participants experienced
a stroke caused by a blood clot and 15 by bleeding in the brain.
Researchers adjusted for several stroke risk
factors such as age, sex, race, cholesterol levels, blood sugar, body
mass index, smoking and blood pressure readings. They found the risk of
stroke was 35 percent higher in those with mild hypertensive retinopathy
and 137 percent higher in those with moderate or severe hypertensive
How does high blood
pressure, also called hypertension, cause vision loss?
HBP can strain the vessels in the eyes and the optic nerve. High
blood pressure can place a strain on the blood vessels in the
eyes. HBP can cause the blood vessels to either narrow or bleed
when they are subjected to too much blood pressure force. Also,
the optic nerve may swell, reducing the ability to see well.
Untreated HBP can cause permanent vision problems. Using
an opthalmoscope, a healthcare professional can look at the
network of tiny capillaries on the retina to evaluate the
condition of the blood vessels in the eyes. Managing blood
pressure is the only way to treat hypertensive retinopathy. HBP
damage is cumulative, so the longer it goes untreated, the
higher the likelihood of permanent damage.
HBP can cause a
stroke, which may lead to brain damage causing vision loss. High
blood pressure can lead to stroke, which, in turn, can impair
the optic nerve or damage the area of the brain responsible for
Even in patients on medication and achieving good
blood pressure control, the risk of a blood clot was 96 percent higher
in those with mild hypertensive retinopathy and 198 percent higher in
those with moderate or severe hypertensive retinopathy.
"It is too early to recommend changes in clinical
practice," Ikram said. "Other studies need to confirm our findings and
examine whether retinal imaging can be useful in providing additional
information about stroke risk in people with high blood pressure."
Co-authors are Yi-Ting Ong, B.Sc.; Tien Y. Wong,
M.D., Ph.D.; Ronald Klein, M.D., M.P.H.; Barbara Klein, M.D., M.P.H.;
Paul Mitchell, M.D., Ph.D.; Richey Sharrett, Dr.P.H.; and David J.
Couper, Ph.D. Author disclosures are on the manuscript.
The National Heart, Lung, and Blood Institute
funded the study.
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