Retinal microvascular signs and recurrent vascular events in patients with TIA or minor stroke

作     者：Philipp Klyscz Thomas Ihl Inga Laumeier Maureen Steinicke Matthias Endres Georg Michelson Heinrich J Audebert 

作者机构：NeurologyCharité-Universitätsmedizin BerlinBerlinGermany Center for Stroke Research BerlinCharité-Universitätsmedizin BerlinBerlinGermany Berlin Institute of HealthBerlinGermany Excellence Cluster NeuroCureCharité-Universitätsmedizin BerlinBerlinGermany German Center for Neurodegenerative Diseasespartner site BerlinGermany German Center for Cardiovascular Researchpartner site BerlinGermany OphthalmologyFriedrich-Alexander-Universität Erlangen-Nürnberg Medizinische FakultätErlangenGermany Talkingeyes&More GmbHErlangenGermany 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)

年 卷 期：2023年第8卷第5期

页      面：379-386,I0001-I0007页

核心收录：

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

基　　金：The INSPIRE-TMS trial was funded by the German Federal Ministry of Education and Research Pfizer and German Stroke Foundation. 

主　　题：patients Retinal prevention 

摘      要：Background and purpose Retinal pathologies are an independent risk factor for ischaemic stroke,but research on the predictive value of retinal abnormalities for recurrent vascular events in patients with prior stroke is inconclusive.We investigated the association of retinal pathologies with subsequent vascular events.Methods In a substudy of the Intensified secondary prevention intending a reduction of recurrent events in TIA and minor stroke patients(INSPiRE-TMS)trial,we enrolled patients with recent transient ischaemic attack(TIA)or minor stroke with at least one modifiable risk factor.Primary outcome was the composite of subsequent vascular events.Retinal photographs were taken at baseline and categorised into three different fundus groups by a telemedically linked ophthalmologist.Results 722 patients participated in the current study and 109 major vascular events occurred.After multivariable adjustments,we did not find a significant association between fundus categories and risk for subsequent vascular events(HRs for moderate vascular retinopathy and vascular retinopathy with vessel rarefaction in comparison to no vascular retinopathy 1.03(95%CI 0.64 to 1.67),p=0.905 and 1.17(95%CI 0.62 to 2.20),p=0.626).In a selective post hoc analysis in patients with diabetes mellitus and hypertension,patients with vascular retinopathy with vessel rarefaction had a higher risk for recurrent stroke(HR 24.14(95%CI 2.74 to 212.50),p=0.004).Conclusions Retinal changes did not predict major subsequent vascular events in patients with recent TIA or minor stroke.Further studies are needed to examine the utility of fundus photography in assessing the risk of stroke recurrence in patients with diabetes mellitus and hypertension.