Elsevier

Japanese Journal of Ophthalmology

Volume 46, Issue 2, March–April 2002, Pages 209-214
Japanese Journal of Ophthalmology

Clinical investigations
Retinal Vascular Obstruction and Asymptomatic Cerebral Infarction

https://doi.org/10.1016/S0021-5155(01)00500-7Get rights and content

Abstract

Purpose: The purpose of this study is to clarify the relationship between retinal vascular obstruction and asymptomatic cerebral infarction (ACI).

Methods: Forty-three patients (27 men and 16 women) with retinal vascular obstruction were examined by magnetic resonance imaging (MRI) at the Department of Ophthalmology of Nagasaki University Hospital in Nagasaki, Japan. Patients with a history of neurological signs and symptoms were excluded from this study. The control group consisted of 93 male and 49 female patients who were examined by MRI for routine brain screening examinations at the Takaki Neurosurgical Clinic in Fukuoka, Japan. We investigated the incidence of ACI, and the risk factors and characteristics of this condition.

Results: ACI was more common in patients with retinal vascular obstruction than in normal adults at all ages. The incidence of hypertension in the patients with ACI tended to be higher than in the patients without ACI.

Conclusion: ACI appears more frequently in patients with retinal vascular obstruction than in normal adults. Our results indicate that either retinal artery occlusion or retinal vein occlusion should be considered a sign of ACI and systemic diseases such as arteriosclerosis.

Introduction

Asymptomatic cerebral infarction (ACI) is sometimes seen in computed tomography (CT) and magnetic resonance imaging (MRI) of apparently healthy adults, and it is considered to be a sign of symptomatic cerebral disturbance. ACI is defined as cerebral infarction with no clinical cerebrovascular signs or symptoms.1 A number of studies have examined the risk factors for ACI.2, 3, 4 Many systemic factors such as hypertension, diabetes, and cardiovascular disease have been evaluated. They are consistent with those of retinal vascular obstruction. However, the relationship between ACI and retinal vascular obstruction has never been described,3 and there is little information on the incidence of ACI in patients with retinal vascular obstruction, on the clinical features of such patients, or on the relationship between retinal vascular obstruction and ACI. The purpose of this study is to compare patients with retinal vascular obstruction and normal adults with respect to the incidence, characteristics and factors related to asymptomatic cerebral infarction.

Section snippets

Materials and Methods

Forty-three patients (27 men and 16 women) with retinal vascular obstruction were examined by MRI at the Department of Ophthalmology of Nagasaki University Hospital in Nagasaki, Japan, between January 1987 and August 1998. Patients with a history of neurological signs and symptoms were excluded from this study. Patients with retinal vascular obstruction were examined by MRI to determine whether or not they had had ACI. All patients with retinal artery occlusion (RAO) and retinal vein occlusion

Results

Of the 43 patients with retinal vascular obstruction, 12 (8 men and 4 women) had RAO and 31 (19 men and 12 women) had RVO (Figure 1). The mean age of the patients with RAO was 60.8 years, ranging from 14 to 87 years, and that of the patients with RVO was 61.0 years, ranging from 37 to 79 years (Figure 1). The percentages of patients with RAO and ACI increased with age; from 50.0% in patients 41 to 50 years of age to 100% in those 61 years of age or older (Figure 2). The percentage of patients

Discussion

There is little information about the relationship between retinal vascular obstruction and ACI. Wijman et al5 reported the incidence of cerebral microembolism detected by transcranial Doppler ultrasonography in patients with clinical evidence of retinal ischemia, including transient monocular blindness, central and branch retinal artery infarction, and ischemic oculopathy. Microembolisms were detected in 40.0% of middle cerebral arteries in the study group and in 9.2% of the controls. However,

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