Relationship between retinal vascular lesions and cerebral microbleeds / 中国脑血管病杂志

ABSTRACT

Objective To investigate the relationship between retinal vascular lesions and cerebral microbleeds ( CMBs) . Methods One hundred twenty-three consecutive patients with cerebral infarction who could sit and finish fundus photography at the Department of Neurology, General Hospital of Beijing Military Command from August 2013 to August 2014 were enrolled prospectively. After informed consent, the patients underwent head MRI examination and bilateral eye fundus photography. They were divided into either a cerebral microbleed group ( CMB group, n =52 ) or a non-cerebral microbleed group ( nCMB group,n=71) according to whether they had CMBs or not. The general clinical data and retinal vascular lesions ( microaneurysms,hard exudates,cotton wool spots,bleeding spots,focal retinal arteriolar narrowing, arteriovenous cross sign,and silver thread-like changes) of both groups were compared. Results (1)There were significant differences in age,hypertension,diabetes,systolic blood pressure,diastolic blood pressure, fasting blood-glucose,triglyceride,and C reaction protein between the CMB group and the non-CMB group (all P<0. 05). (2) The incidences of hard exudates,focal retinal arteriolar narrowing,and arteriovenous cross sign of patients with CMB were higher than those with non-CMB,and there were significant differences (χ2 =6.233,7.675,and9.544,respectively;P=0.040,0.031,and0.019,respectively).(3)There were significant differences in the incidences of hard exudates,focal retinal arteriolar narrowing,and arteriovenous cross sign in patients with different severity of CMBs (Z= -2. 317,-2. 294 and -2. 157,respectively;P=0. 029,0. 033,and 0. 039,respectively). In patients with severe CMB,there were more patients with hard exudates,focal retinal arteriolar narrowing,and arteriovenous cross sign. (4) The age (OR,3. 623, 95%CI 2. 631-7. 866),hypertension (OR,4. 348,95%CI 3. 734-10. 563),diabetes (OR,3. 831,95%CI 2.126-9. 245),fasting blood-glucose (OR,3. 329,95%CI 2. 631-11. 012),arteriovenous cross sign (OR,5. 437,95%CI 3. 441-13. 606),and hard exudates (OR,4. 054,95%CI 3. 137-13. 252) were the independent risk factors for the occurrence of CMBs. Conclusion The arteriovenous cross sign, focal retinal artery narrowing,and hard exudates in retinal vascular lesions are associated with the CMBs and different degree of CMBs classification. Both the arteriovenous cross sign and hard exudates are the independent risk factors for CMBs.