Qiu Chengxuan, Cotch Mary Frances, Sigurdsson Sigurdur, Klein Ronald, Jonasson Fridbert, Klein Barbara E K, Garcia Melissa, Jonsson Palmi V, Harris Tamara B, Eiriksdottir Gudny, Kjartansson Olafur, van Buchem Mark A, Gudnason Vilmundur, Launer Lenore J
Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, 7201 Wisconsin Avenue, Bethesda, MD 20892, USA.
Ann Neurol. 2009 May;65(5):569-76. doi: 10.1002/ana.21614.
To investigate whether the severity and location of cerebral white matter hyperintensities (WMHs) and brain infarcts are correlated with the signs of retinal microvascular abnormalities in the elderly.
The study included 4,176 men and women (mean age, 76 years) who participated in the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study. Digital retinal images of both dilated eyes were taken and evaluated for the presence of retinal focal arteriolar signs (focal arteriolar narrowing and arteriovenous nicking) and retinopathy lesions (retinal blot hemorrhages and microaneurysms). Brain magnetic resonance imaging scans were acquired and evaluated for the presence and distribution of cerebral infarcts and WMHs. Logistic and multinomial logistic models were constructed to estimate the association of retinal microvascular signs to brain lesions.
Controlling for demographic and major cardiovascular risk factors, we found that retinal focal arteriolar signs, but not retinopathy lesions, were significantly associated with an increasing load of subcortical and periventricular WMHs. The strongest association was found between retinal arteriolar signs and a heavier WMH load, specifically in the subcortical frontal lobe, and periventricular frontal and parietal caps. There was a tendency toward bilateral retinal focal arteriolar narrowing being more strongly associated with the heavier load of subcortical WMHs. Arteriovenous nicking was significantly associated with subcortical infarcts.
In older adults, retinal focal arteriolar signs, but not retinopathy lesions, are correlated with the load of diffuse WMHs, particularly those located in the subcortical frontal lobe, and the periventricular frontal and parietal caps of the brain.
研究老年人脑白质高信号（WMHs）和脑梗死的严重程度及位置是否与视网膜微血管异常体征相关。
该研究纳入了4176名男性和女性（平均年龄76岁），他们参与了年龄、基因/环境易感性（AGES）-雷克雅未克研究。采集双眼散瞳后的数字视网膜图像，评估是否存在视网膜局灶性小动脉体征（局灶性小动脉狭窄和动静脉交叉压迹）和视网膜病变（视网膜点状出血和微动脉瘤）。进行脑磁共振成像扫描，评估脑梗死和WMHs的存在及分布情况。构建逻辑回归和多项逻辑回归模型，以估计视网膜微血管体征与脑病变之间的关联。
在控制了人口统计学和主要心血管危险因素后，我们发现视网膜局灶性小动脉体征而非视网膜病变与皮质下和脑室周围WMHs负荷增加显著相关。视网膜小动脉体征与更严重的WMHs负荷之间的关联最强，特别是在皮质下额叶以及脑室周围额叶和顶叶帽状区域。双侧视网膜局灶性小动脉狭窄与更严重的皮质下WMHs负荷之间存在更强关联的趋势。动静脉交叉压迹与皮质下梗死显著相关。
在老年人中，视网膜局灶性小动脉体征而非视网膜病变与弥漫性WMHs负荷相关，尤其是位于皮质下额叶以及脑室周围额叶和顶叶帽状区域的WMHs。
