Retinal emboli and cardiovascular disease: the Beaver Dam Eye Study

Trans Am Ophthalmol Soc. 2003;101:173-80; discussion 180-2.

Abstract

Purpose: To describe the 10-year incidence of retinal emboli, the associated risk factors, and the relationship of retinal emboli to stroke and ischemic heart disease mortality.

Methods: The Beaver Dam Eye Study (n = 4,926) is a population-based study of persons 43 to 86 years of age. Retinal emboli were detected at baseline (1988-1990) and at a 5-year (1993-1995) and a 10-year (1998-2000) follow-up by grading of stereoscopic 30 degrees color fundus photographs using standardized protocols. Cause-specific mortality was determined from death certificates.

Results: The 10-year cumulative incidence of retinal emboli was 1.5%. While adjusting for age and sex, the incidence of retinal emboli was associated with increased pulse pressure (odds ratio [OR] 4th versus 1st quartile range, 2.42; 95% confidence interval (CI), 0.98-5.97; P test of trend = .03), higher serum total cholesterol (OR, 2.77; 95% CI, 1.06-7.23; P = .03), higher leukocyte count (OR, 2.28; 95% CI, 1.04-4.96; P = .05), smoking status (OR current versus never smoker, 4.60: 95% CI, 2.08-10.16; P < .001), and a history of coronary artery bypass surgery (OR, 7.17; 95% CI, 3.18-16.18; P < .001) at baseline. While controlling for age, sex, and systemic factors, a significantly higher hazard of dying with a mention of stroke on the death certificate was found in people with retinal emboli (hazard ratio, 2.40; 95% CI, 1.16-4.99) compared with those without.

Conclusions: The data show an association of smoking and cardiovascular disease with the incidence of retinal emboli. Also, persons with retinal emboli are at increased risk of stroke-related death.

Publication types

  • Duplicate Publication
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure
  • Cardiovascular Diseases / etiology*
  • Cholesterol / blood
  • Coronary Artery Bypass
  • Embolism / complications
  • Embolism / epidemiology*
  • Female
  • Humans
  • Incidence
  • Leukocyte Count
  • Male
  • Middle Aged
  • Odds Ratio
  • Proportional Hazards Models
  • Retinal Diseases / complications*
  • Retinal Diseases / epidemiology*
  • Retinal Vessels*
  • Smoking
  • Stroke / etiology
  • Stroke / mortality
  • Wisconsin / epidemiology

Substances

  • Cholesterol