Askiel Bruno, MD; William L. Jones, OD; Jeffrey K. Austin, OD; Shelley Carter, RN; Clifford Qualls, PhD
To determine whether asymptomatic retinal cholesterol embolism is a risk factor for vascular events.
Cohort study with retrospectively selected controls.
A Veterans Affairs medical center.
70 consecutive patients with asymptomatic retinal cholesterol emboli on dilated ocular examination in an eye clinic and 70 controls without retinal emboli. Controls were matched to patients for sex; age; prevalence of hypertension, diabetes mellitus, and ischemic heart disease; serum cholesterol level; and smoking history.
Stroke, myocardial infarction, and death.
During a mean follow-up of 3.4 years, stroke occurred at an annual rate of 8.5% among patients and 0.8% among controls (adjusted relative risk, 9.9; 95% CI, 2.3 to 43.1; P = 0.002). Nineteen strokes occurred, 17 in patients and 2 in controls; all were nonfatal cerebral infarctions. Twelve of the 17 that occurred in patients were in a carotid artery territory ipsilateral to the qualifying retinal cholesterol embolus and 5 were in another vascular territory. Ocular infarction or hemorrhagic stroke did not occur. Nonfatal myocardial infarction or vascular death occurred at an annual rate of 7.7% among patients and 4.9% among controls (adjusted relative risk, 1.4; 95% CI, 0.7 to 2.9; P = 0.39).
Asymptomatic retinal cholesterol embolism is an important risk factor for cerebral infarction independent of commonly recognized vascular risk factors.
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Bruno A, Jones WL, Austin JK, Carter S, Qualls C. Vascular Outcome in Men with Asymptomatic Retinal Cholesterol Emboli: A Cohort Study. Ann Intern Med. 1995;122:249–253. doi: 10.7326/0003-4819-122-4-199502150-00002
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Published: Ann Intern Med. 1995;122(4):249-253.
Cardiology, Coronary Heart Disease, Emergency Medicine, Neurology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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