Can Your Eyes Be a Window to Your Stroke Risk?

Your eyes may be a window to your soul, but could they also be a window to your stroke risk?

In a recent study detailed in the American Heart Association journal Hypertension, researchers state that retinal imaging may someday help assess if a person is more likely to develop a stroke.  This could be an invaluable diagnostic discovery – strokes Eyes and Strokesare the nation’s No. 4 killer and a leading cause of disability.

“The retina provides information on the status of blood vessels in the brain,” said Mohammad Kamran Ikram, M.D., Ph.D., lead author of the study and assistant professor in the Singapore Eye Research Institute, the Department of Ophthalmology and Memory Aging & Cognition Centre, at the National University of Singapore. “Retinal imaging is a non-invasive and cheap way of examining the blood vessels of the retina.”

Globally, high blood pressure is the single most important risk factor for stroke. However, until now there has not been a reliable way to predict which high blood pressure patients are more likely to develop a stroke.


Researchers tracked stroke occurrence for an average 13 years in 2,907 patients with high blood pressure who had not previously experienced a stroke. At the baseline, each patient had photographs taken of the retina, the light-sensitive layer of cells at the back of the eyeball. Damage to the retinal blood vessels attributed to hypertension — called hypertensive retinopathy — evident on the patient photographs was scored as one of four ways: none, mild, moderate, or severe.


During the follow-up, 161 participants experienced a stroke: 146 caused by a blood clot and 15 by bleeding in the brain.

After adjusting for several stroke risk factors such as age, sex, race, cholesterol levels, blood sugar, body mass index, smoking and blood pressure readings, researchers found the risk of stroke was 35 percent higher in those with mild hypertensive retinopathy and 137 percent higher in those with moderate or severe hypertensive retinopathy.  The researchers determined that even in patients whose blood pressure was successfully controlled by medication, the risk of a blood clot was 96 percent higher in those with mild hypertensive retinopathy and 198 percent higher in those with moderate or severe hypertensive retinopathy.

While this research opens the door for early risk detection in patients with hypertension, Ikram states “It is too early to recommend changes in clinical practice, other studies need to confirm our findings and examine whether retinal imaging can be useful in providing additional information about stroke risk in people with high blood pressure.”

More research is being done on the benefits of retinal imaging. But one thing is for sure:  retinal imaging would be an inexpensive and non-invasive way to assess risk.

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