Prevalence and associations of retinal emboli with Asian ethnicity, stroke and renal disease: The Singapore epidemiology of eye disease study

Session Details

Session Title: Free Paper Session 16: Vascular Diseases & Diabetic Retinopathy IV

Session Date/Time: Friday 08/09/2017 | 16:30-18:00

Paper Time: 17:24

Venue: Room 114

First Author: : N.Cheung SINGAPORE

Co Author(s): :    K. Teo   W. Zhao   J. Wang   P. Mitchell   C. Cheng   T. Wong              

Abstract Details


To examine the prevalence and risk factors for retinal emboli in a large, contemporary, multi-ethnic Asian population.


Population-based cross-sectional study. A total of 10,033 Chinese, Malay and Indian persons, aged 40 to 80 years, residing in the general communities of Singapore.


Retinal emboli were ascertained from retinal photographs obtained from both eyes of all the participants according to a standardized protocol. Age-standardized prevalence of retinal emboli was calculated using the 2010 Singapore adult population. Risk factors were assessed from comprehensive systemic and ophthalmic examinations, interviews and laboratory investigations.


Of the 10,033 participants, 9,978 (99.5%) had gradable retinal photographs. The overall person-specific, age-standardized prevalence of retinal emboli was 0.75% (confidence interval [CI] 0.60, 0.95), with the highest prevalence seen in the Indian cohort (0.98%), followed by the Chinese (0.73%) and Malay (0.44%) cohorts (p=0.03). In multi-variable adjusted analysis, factors associated with prevalent retinal emboli included older age (odds ratio [OR] 1.22; 95 CI: 1.05, 1.41 per 5-year increase), Indian ethnicity (OR 3.58; 95% CI: 1.95, 6.60; compared to Malay ethnicity), hypertension (OR 1.95; CI: 1.03, 3.70), chronic kidney disease (OR 2.05; CI: 1.15, 3.64), creatinine (OR 1.13; CI: 1.05, 1.21; per standard deviation [SD] increase), glomerular filtration rate (OR 0.67; 95% CI: 0.51, 0.86; per SD increase), and history of stroke (OR 3.45; 95% CI: 1.70, 6.99).


Among the three major Asian ethnic populations examined in this study, retinal emboli were most commonly seen in Indians, and associated with conventional cardiovascular risk factors, stroke and chronic kidney disease. Its presence may therefore signal vascular embolic event and damage not only in the brain but also in the kidneys. Persons with retinal emboli may require both general cardiovascular and renal assessment.

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