>Diabetic retinopathy appears to predict incident ischemic stroke in people with diabetes, independent of other risk factors. According to a report in Stroke, the relationship between diabetic retinopathy and ischemic stroke is uncertain. Therefore investigators from the University of Melbourne in Australia undertook a study to examine the link. “Diabetes can exert its effects on multiple organs in the body,” said author Tien Y. Wong, MD, PhD, in an interview with Reuters Health. “Damage in the eye is a marker of probably unseen damage occurring elsewhere. Blood vessel damage in the eye is linked to blood vessel damage in the brain, heralding the onset of stroke.” Dr. Wong is Professor of Ophthalmology and Deputy Director of the Centre for Eye Research Australia at the University of Melbourne.

In a population-based, prospective cohort study of 1,617 middle-aged people with diabetes, Dr. Wong and colleagues ascertained evidence of diabetic retinopathy signs from retinal photographs. Incident ischemic stroke events were prospectively identified and validated, according to the report.

During an average follow-up of almost 8 years, the investigators reported 75 ischemic stroke events. After adjustment for the following stroke risk factors: age, gender, race, center, 6-year mean arterial blood pressure, antihypertensive treatment use, fasting glucose, insulin treatment, duration of diabetes, HDL and LDL cholesterol levels, and cigarette smoking status, diabetic retinopathy was associated with an increased risk of ischemic stroke (hazard rate ratio, 2.34; 95% confidence index, 1.13 to 4.86).

The investigators concluded that diabetic retinopathy predicts incident ischemic stroke in people with diabetes, independent of other risk factors. For ophthalmologists, these results show that if retinopathy is detected in a patient who has diabetes, the person may require a more comprehensive assessment of their stroke risk, Dr. Wong said.

Tien Y. Wong, MD, PhD, is Professor of Ophthalmology and Deputy Director of the Centre for Eye Research Australia, University of Melbourne. He may be reached at twong@unimelb.edu.au.

Cheung N, Rogers S, Couper DJ, et al. Is diabetic retinopathy an independent risk factor for ischemic stroke? Stroke. 2007;38:398-401.