Are retinopathy signs markers of cerebrovascular disease and neurodegeneration in the brain? The epidemiology of dementia in Singapore study

Session Details

Session Title: Free Paper Session 19: Vascular Diseases & Diabetic Retinopathy V

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

Paper Time: 16:54

Venue: Room 120

First Author: : N.Cheung SINGAPORE

Co Author(s): :    Y. Shi   S. Hilal   X. Xu   C. Cheng   C. Chen   T. Wong              

Abstract Details


To examine the associations of retinopathy signs with magnetic resonance imaging (MRI) markers of cerebrovascular disease (CeVD) and neurodegeneration in the brain.


A cross-sectional analysis of 815 participants, aged 60 years or older, recruited from a multi-ethnic population-based study in Singapore.


Participants had a comprehensive battery of neuropsychological tests, clinical and laboratory examinations, retinal photography and brain MRI scans according to standardized protocols.


Of the 815 participants, 13.7% had signs of retinopathy. In multivariate analysis adjusted for age, gender, ethnicity, smoking, body mass index, and levels of blood pressure, cholesterol and glycosylated haemoglobin, the presence of any retinopathy was significantly associated with one-step increase in MRI CeVD burden score (odds ratio [OR] 1.72; 95% confidence interval: 1.10, 2.67), and also with individual MRI markers of lacunar infarct (OR 1.75; CI: 1.03, 3.01), white matter lesions (OR 2.76; CI 1.07, 6.64), and medial temporal atrophy (OR 1.62; CI 1.04, 2.51). For individual component sign of retinopathy, the associations of retinal haemhorrages and microaneurysms were similar to that of any retinopathy, while retinal hard exudate was associated with cerebral microbleeds (OR 3.00; CI 1.23, 7.54). For vision-threatening diabetic retinopathy, clinically significant macular edema was associated with cortical cerebral microinfarcts (OR 22.48; CI 3.39, 145.3), medial temporal atrophy (OR 10.7; CI 2.12, 53.5) and CeVD burden (OR 6.42; CI 1.58, 27.0), while proliferative diabetic retinopathy was associated with intracranial stenosis (OR 7.80; CI: 2.14, 28.5), cortical (OR 4.60; CI 1.47, 14.5) and medial temporal atrophy (OR 3.91; CI 1.18, 13.0). Any retinopathy or macular edema was also significantly and negatively correlated with measures of cognitive function.


Retinopathy signs and macular edema are associated with MRI markers of cerebrovascular disease and neurodegeneration in the brain. These retinal signs are also negatively correlated with cognitive function. These findings may further pathophysiological insights into common microvascular and neurodegenerative processes in the brain and retina.

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