Prediction of incident stroke events based on retinal vessel caliber: A systematic review and individual-participant meta-analysis

Kevin McGeechan, Gerald Liew, Petra MacAskill, Les Irwig, Ronald Klein, Barbara E.K. Klein, Jie Jin Wang, Paul Mitchell, Johannes R. Vingerling, Paulus T.V.M. De Jong, Jacqueline C.M. Witteman, Monique M.B. Breteler, Jonathan Shaw, Paul Zimmet, Tien Y. Wong

Research output: Contribution to journalArticleResearchpeer-review

184 Citations (Scopus)

Abstract

The caliber of the retinal vessels has been shown to be associated with stroke events. However, the consistency and magnitude of association, and the changes in predicted risk independent of traditional risk factors, are unclear. To determine the association between retinal vessel caliber and the risk of stroke events, the investigators combined individual data from 20,798 people, who were free of stroke at baseline, in 6 cohort studies identified from a search of the Medline (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier B.V., Amsterdam, the Netherlands) databases. During follow-up of 5-12 years, 945 (4.5%) incident stroke events were recorded. Wider retinal venular caliber predicted stroke (pooled hazard ratio=1.15, 95% confidence interval: 1.05, 1.25 per 20-μm increase in caliber), but the caliber of retinal arterioles was not associated with stroke (pooled hazard ratio=1.00, 95% confidence interval: 0.92, 1.08). There was weak evidence of heterogeneity in the hazard ratio for retinal venular caliber, which may be attributable to differences in follow-up strategies across studies. Inclusion of retinal venular caliber in prediction models containing traditional stroke risk factors reassigned 10.1% of people at intermediate risk into different, mostly lower, risk categories.

Original languageEnglish
Pages (from-to)1323-1332
Number of pages10
JournalAmerican Journal of Epidemiology
Volume170
Issue number11
DOIs
Publication statusPublished - 1 Dec 2009
Externally publishedYes

Keywords

  • Cohort studies
  • Meta-analysis
  • Retinal vessels
  • Risk
  • Stroke

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