Large-artery stiffness is a risk factor for
stroke, including
cerebral small-vessel disease.
Retinal microvascular changes are thought to mirror those in cerebral microvessels. We investigated the relationship between aortic stiffness and
retinal microvascular changes in Asian
ischemic stroke patients. We studied 145
acute ischemic stroke patients in Singapore who had aortic stiffness measurements using carotid-femoral pulse wave velocity (cPWV).
Retinal photographs were assessed for
retinal microvessel caliber and qualitative signs of focal arteriolar narrowing, arteriovenous nicking and enhanced arteriolar light reflex. Aortic stiffening was associated with
retinal arteriolar changes.
Retinal arteriolar caliber decreased with increasing cPWV (r=-0.207, P=0.014). After adjusting for age, gender,
hypertension, diabetes, mean arterial pressure and small-vessel
stroke subtype, patients within the highest cPWV quartile were more likely to have generalized
retinal arteriolar narrowing defined as lowest caliber tertile (odds ratio (OR) 6.84, 95% confidence interval (CI) 1.45-32.30), focal arteriolar narrowing (OR 13.85, CI 1.82-105.67), arteriovenous nicking (OR 5.08, CI 1.12-23.00) and enhanced arteriolar light reflex (OR 3.83, CI 0.89-16.48), compared with those within the lowest quartile. In
ischemic stroke patients, aortic stiffening is associated with
retinal arteriolar
luminal narrowing as well as features of
retinal arteriolosclerosis.