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Journal of the Korean Neurological Association 2006;24(5): 440-446.
허혈성 뇌졸중 환자에서 망막 미세혈관 변성의 의의
구대림, 고성호 김현영 이규용 이영주 김희태 김승현 김주한 김명호
한양대학교 의과대학 신경과학교실
Significance of Retinal Microvascular Changes in Patients with Ischemic Stroke
Dae-Lim Koo,
Department of Neurology, Hanyang University Collage of Medicine, Guri, Korea
Abstract
Background: Retinal microvascular abnormalities reflect cerebral microvascular changes. However, there is few clinical data on the relationship between retinal microvascular changes and intracranial arterial stenosis or stroke subtypes. We examined the association between white matter changes (WMCs) or large artery stenosis and retinal microvascular changes, stroke subtypes.
Methods: We investigated demographic features, retinal microvascular changes, intracranial large arterial stenosis, WMCs and stroke subtypes in 100 acute ischemic stroke patients over 2 years who had taken retinal photography and underwent brain MRI with MR angiography. Retinal photography was evaluated for specific retinal microvascular change by grader using standardized protocol. Intracranial arterial stenosis was defined by MR angiography. WMCs were coded from 1 for normal to 8 for most severe degree. And we defined “White matter lesion” as grade 3 or more. Stroke subtypes were classified by TOAST criteria.
Results: Among the retinal microvascular changes, retinal hemorrhage, arteriovenous nicking, focal and generalized arteriolar narrowing and venous congestion were significantly correlated with intracranial large arterial stenosis. There was no relationship between the retinal microvascular changes and stroke subtypes. And only focal arteriolar narrowing was significantly correlated with WML.
Conclusions: Retinal microvascular changes seen in patients with ischemic stroke were related to intracranial large arterial stenosis. We might suggest that the pathogenesis of retinal microvascular changes is related to that of large arterial atherosclerosis.KeyWords:Retinal microvascular abnormalities, Intracranial arterial stenosis, White matter changes