Opin vísindi

Differential associations between retinal signs and CMBs by location

Differential associations between retinal signs and CMBs by location

Title: Differential associations between retinal signs and CMBs by location
Author: Qiu, Chengxuan
Ding, Jie
Sigurðsson, Sigurður
Fisher, Diana E.
Zhang, Qian
Eiriksdottir, Gudny   orcid.org/0000-0002-8197-0652
Klein, Ronald
van Buchem, Mark A.
Gudnason, Vilmundur   orcid.org/0000-0001-5696-0084
Cotch, Mary Frances
... 1 more authors Show all authors
Date: 2017-12-13
Language: English
Scope: e142-e148
University/Institute: Háskóli Íslands
University of Iceland
School: Heilbrigðisvísindasvið (HÍ)
School of Health Sciences (UI)
Department: Læknadeild (HÍ)
Faculty of Medicine (UI)
Series: Neurology;90(2)
ISSN: 0028-3878
1526-632X (eISSN)
DOI: 10.1212/WNL.0000000000004792
Subject: Heilablóðfall; Háþrýstingur; Aldurshópar; Erfðagreining; Rannsóknir
URI: https://hdl.handle.net/20.500.11815/863

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Qiu, C., Ding, J., Sigurdsson, S., Fisher, D. E., Zhang, Q., Eiriksdottir, G., . . . Launer, L. J. (2018). Differential associations between retinal signs and CMBs by location. The AGES-Reykjavik Study, 90(2), e142-e148. doi:10.1212/wnl.0000000000004792


Objective To test the hypothesis that age-related macular degeneration (AMD) and retinal microvascular signs are differentially associated with lobar and deep cerebral microbleeds (CMBs). Methods CMBs in lobar regions indicate cerebral amyloid angiopathy (CAA). β-Amyloid deposits are implicated in both CAA and AMD. Deep CMBs are associated with hypertension, a major risk factor for retinal microvascular damage. This population-based cohort study included 2,502 participants in the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study who undertook binocular digital retinal photographs at baseline (2002–2006) to assess retinal microvascular signs and AMD and brain MRI scan at both baseline and follow-up (2007–2011) to assess CMBs. We assessed retinal microvascular lesion burden by counting the 3 retinal microvascular signs (focal arteriolar narrowing, arteriovenous nicking, and retinopathy) concurrently present in the participant. We used multiple logistic models to examine the association of baseline retinal pathology to incident CMBs detected at follow-up. Results During an average 5.2 years of follow-up, 461 people (18.3%) developed new CMBs, including 293 in exclusively lobar regions and 168 in deep regions. Pure geographic atrophy was significantly associated with strictly lobar CMBs (multivariable-adjusted odds ratio 2.59, 95% confidence interval [CI] 1.01–6.65) but not with deep CMBs. Concurrently having ≥2 retinal microvascular signs was associated with a 3-fold (95% CI 1.73–5.20) increased likelihood for deep CMBs but not exclusively lobar CMBs. Conclusions Retinal microvascular signs and pure geographic atrophy may be associated with deep and exclusively lobar CMBs, respectively, in older people. These results have implications for further research to define the role of small vessel disease in cognitive impairment.


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