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@ARTICLE{Klyscz:257690,
author = {Klyscz, Philipp and Ihl, Thomas and Laumeier, Inga and
Steinicke, Maureen and Endres, Matthias and Michelson, Georg
and Audebert, Heinrich J},
title = {{R}etinal microvascular signs and recurrent vascular events
in patients with {TIA} or minor stroke.},
journal = {Stroke and vascular neurology},
volume = {8},
number = {5},
issn = {2059-8688},
address = {London},
publisher = {BMJ},
reportid = {DZNE-2023-00487},
pages = {379-386},
year = {2023},
abstract = {Retinal pathologies are an independent risk factor for
ischaemic stroke, but research on the predictive value of
retinal abnormalities for recurrent vascular events in
patients with prior stroke is inconclusive. We investigated
the association of retinal pathologies with subsequent
vascular events.In a substudy of the Intensified secondary
prevention intending a reduction of recurrent events in TIA
and minor stroke patients (INSPiRE-TMS) trial, we enrolled
patients with recent transient ischaemic attack (TIA) or
minor stroke with at least one modifiable risk factor.
Primary outcome was the composite of subsequent vascular
events. Retinal photographs were taken at baseline and
categorised into three different fundus groups by a
telemedically linked ophthalmologist.722 patients
participated in the current study and 109 major vascular
events occurred. After multivariable adjustments, we did not
find a significant association between fundus categories and
risk for subsequent vascular events (HRs for moderate
vascular retinopathy and vascular retinopathy with vessel
rarefaction in comparison to no vascular retinopathy 1.03
$(95\%$ CI 0.64 to 1.67), p=0.905 and 1.17 $(95\%$ CI 0.62
to 2.20), p=0.626). In a selective post hoc analysis in
patients with diabetes mellitus and hypertension, patients
with vascular retinopathy with vessel rarefaction had a
higher risk for recurrent stroke (HR 24.14 $(95\%$ CI 2.74
to 212.50), p=0.004).Retinal changes did not predict major
subsequent vascular events in patients with recent TIA or
minor stroke. Further studies are needed to examine the
utility of fundus photography in assessing the risk of
stroke recurrence in patients with diabetes mellitus and
hypertension.},
keywords = {Humans / Stroke: diagnosis / Stroke: epidemiology / Stroke:
complications / Ischemic Attack, Transient: diagnosis /
Brain Ischemia / Hypertension: complications / Retinal
Diseases: diagnosis / Retinal Diseases: epidemiology /
Retinal Diseases: complications / Diabetes Mellitus /
cerebral infarction (Other) / ischemic attack, transient
(Other) / stroke (Other)},
cin = {AG Endres},
ddc = {610},
cid = {I:(DE-2719)1811005},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pmc = {pmc:PMC10647888},
pubmed = {pmid:36858463},
doi = {10.1136/svn-2022-001784},
url = {https://pub.dzne.de/record/257690},
}