Klein R, Klein B E, Jensen S C, Moss S E, Meuer S M
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53705-2397, USA.
Arch Ophthalmol. 1999 Aug;117(8):1063-8. doi: 10.1001/archopht.117.8.1063.
To describe the prevalence at baseline and the 5-year incidence of retinal emboli, associated risk factors, and the relationship of retinal emboli at baseline to stroke and ischemic heart disease mortality.
The Beaver Dam Eye Study is a large (N = 4926) population-based study of persons aged 43 to 86 years at the baseline examination. Retinal emboli were detected at baseline (1988-1990) and at a 5-year follow-up (1993-1995) by grading of stereoscopic 30 degrees color fundus photographs using standardized protocols. Cause-specific mortality was determined from death certificates.
The prevalence of retinal arteriolar emboli was 1.3%, and the 5-year incidence was 0.9%. After adjustments were made for age and sex, the prevalence of retinal emboli was associated with higher pulse pressure, hypertension, diabetes mellitus, past and current smoking, cardiovascular disease, and the presence of retinopathy. After adjustments were made for age and sex, the incidence of retinal emboli was associated with past and current smoking and a history of coronary artery bypass surgery. After age, sex, and systemic factors were controlled for, people with retinal emboli had a significantly higher hazard of dying with a mention of stroke on the death certificate (hazard ratio = 2.61, 95% confidence interval = 1.12-6.08) than those without retinal emboli.
Persons with retinal emboli are at an increased risk of stroke-related death. Data also show an association of smoking, hypertension, and cardiovascular disease with the prevalence of retinal emboli.
Data from this population-based study suggest that after discovery of retinal emboli in the asymptomatic patient, referral for possible medical intervention to control hypertension, if present, may be beneficial.
描述视网膜栓子的基线患病率、5年发病率、相关危险因素，以及基线时视网膜栓子与中风和缺血性心脏病死亡率的关系。
比弗迪姆眼研究是一项大规模（N = 4926）的基于人群的研究，研究对象为基线检查时年龄在43至86岁之间的人群。通过使用标准化方案对立体30度彩色眼底照片进行分级，在基线（1988 - 1990年）和5年随访（1993 - 1995年）时检测视网膜栓子。根据死亡证明确定特定病因的死亡率。
视网膜动脉栓子的患病率为1.3%，5年发病率为0.9%。在对年龄和性别进行调整后，视网膜栓子的患病率与较高的脉压、高血压、糖尿病、既往和当前吸烟、心血管疾病以及视网膜病变的存在有关。在对年龄和性别进行调整后，视网膜栓子的发病率与既往和当前吸烟以及冠状动脉搭桥手术史有关。在控制了年龄、性别和全身因素后，视网膜栓子患者在死亡证明上提及中风的死亡风险显著高于无视网膜栓子患者（风险比 = 2.61，95%置信区间 = 1.12 - 6.08）。
视网膜栓子患者中风相关死亡风险增加。数据还显示吸烟、高血压和心血管疾病与视网膜栓子的患病率有关。
这项基于人群的研究数据表明，在无症状患者中发现视网膜栓子后，如果存在高血压，转诊进行可能的医学干预以控制高血压可能是有益的。
