Wong Tien Yin
Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria.
Lancet Neurol. 2004 Mar;3(3):179-83. doi: 10.1016/s1474-4422(04)00682-9.
The retinal microcirculation can be viewed non-invasively to give a unique perspective of the cerebral microcirculation in vivo. Studying pathological changes of retinal blood vessels (microaneurysms, retinal haemorrhages, and retinal arteriolar narrowing) may help to understand the causes of various cerebrovascular disorders. Retinal photography provides such an opportunity.
Several recent studies have shown that retinal microvascular changes are reliably documented by retinal photographs. These retinopathy changes seem to be fairly common in the general population, even in people without hypertension or diabetes. Retinopathy is related to incident clinical stroke and stroke mortality and to MRI-defined subclinical cerebral white-matter lesions and cerebral atrophy, independent of blood pressure, diabetes, and other cerebrovascular risk factors. WHERE NEXT?: Retinal microvascular abnormalities seem to be markers of concomitant cerebral microangiopathy, and retinal photography may be useful for the investigation of microvascular disorders of the brain in clinical and epidemiological settings. Future research should be aimed at the development of standardised photographic methods for the assessment of retinal microvascular changes, the replication of these findings in other populations and in people with other cerebrovascular disorders, and the examination of the increased accuracy of stoke-risk stratification given by retinal photography
视网膜微循环可通过无创方式进行观察，从而为活体脑微循环提供独特视角。研究视网膜血管的病理变化（微动脉瘤、视网膜出血和视网膜小动脉狭窄）可能有助于了解各种脑血管疾病的病因。视网膜摄影提供了这样一个机会。
最近的几项研究表明，视网膜微血管变化可通过视网膜照片可靠记录。这些视网膜病变变化在普通人群中似乎相当常见，即使在没有高血压或糖尿病的人群中也是如此。视网膜病变与临床中风事件、中风死亡率以及磁共振成像定义的亚临床脑白质病变和脑萎缩相关，独立于血压、糖尿病和其他脑血管危险因素。
视网膜微血管异常似乎是伴随脑微血管病变的标志物，视网膜摄影可能有助于在临床和流行病学环境中研究脑部微血管疾病。未来的研究应致力于开发用于评估视网膜微血管变化的标准化摄影方法，在其他人群和患有其他脑血管疾病的人群中复制这些发现，并研究视网膜摄影在提高中风风险分层准确性方面的作用。
