Vascular outcome in men with asymptomatic retinal cholesterol emboli. A cohort study.

Abstract

OBJECTIVE:

To determine whether asymptomatic retinal cholesterol embolism is a risk factor for vascular events.

DESIGN:

Cohort study with retrospectively selected controls.

SETTING:

A Veterans Affairs medical center.

PATIENTS:

70 consecutive patients with asymptomatic retinal cholesterol emboli on dilated ocular examination in an eye clinic and 70 controls without retinal emboli. Controls were matched to patients for sex; age; prevalence of hypertension, diabetes mellitus, and ischemic heart disease; serum cholesterol level; and smoking history.

MEASUREMENTS:

Stroke, myocardial infarction, and death.

RESULTS:

During a mean follow-up of 3.4 years, stroke occurred at an annual rate of 8.5% among patients and 0.8% among controls (adjusted relative risk, 9.9; 95% CI, 2.3 to 43.1; P = 0.002). Nineteen strokes occurred, 17 in patients and 2 in controls; all were nonfatal cerebral infarctions. Twelve of the 17 that occurred in patients were in a carotid artery territory ipsilateral to the qualifying retinal cholesterol embolus and 5 were in another vascular territory. Ocular infarction or hemorrhagic stroke did not occur. Nonfatal myocardial infarction or vascular death occurred at an annual rate of 7.7% among patients and 4.9% among controls (adjusted relative risk, 1.4; 95% CI, 0.7 to 2.9; P = 0.39).

CONCLUSION:

Asymptomatic retinal cholesterol embolism is an important risk factor for cerebral infarction independent of commonly recognized vascular risk factors.

• Authors: A Bruno, W L Jones, J K Austin, S Carter, C Qualls
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 122 Issue 4 Pg. 249-53 (Feb 15 1995) ISSN: 0003-4819 [Print] United States
• PMID: 7825759 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Topics

• Aged
• Cardiovascular Diseases (etiology, mortality)
• Cerebral Infarction (etiology, mortality)
• Embolism, Cholesterol (complications)
• Follow-Up Studies
• Humans
• Male
• Myocardial Infarction (etiology, mortality)
• Proportional Hazards Models
• Retinal Diseases (complications)
• Retrospective Studies
• Risk Factors