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Diabetic retinopathy as an indicator of other serious health risk

Eye health may indicate stroke risk

The risk of experiencing a stroke has been shown to be higher in individuals with diabetic retinopathy.

The latest findings from the ACCORD Eye study (Action to Control Cardiovascular Risk in Diabetes) were unveiled at the International Stroke Conference.

Diabetic retinopathy is a common diabetes complication which is caused by consistent high blood sugar levels damaging the back of the eye.

According to the World Health Organisation, diabetic retinopathy is the cause of visual impairment for 4.2 million people.

Lead author Dr Ka-Ho Wong, said: “As we know, large-artery atherosclerosis and atrial fibrillation are the primary causes of ischemic stroke. However, microvascular disease of the brain is also a cause of stroke and of vascular dementia.

“Diabetic retinopathy is a common microvascular complication of diabetes, and we hypothesized that retinopathy would be an important biomarker of stroke risk in diabetic patients, and one that may precede ischemic stroke.”

The research involved analysing the eyes of 2,828 people with diabetes. Just over five years later the researchers followed up with the participants and found that 117 people had experienced a stroke.
Among those who experienced a stroke, 41% had diabetic retinopathy, whereas only 30.5% of people who did not have experience a stroke had diabetic retinopathy.

Dr Wong said: “Patients with established diabetic retinopathy should pay particular attention to meeting all stroke prevention guidelines established by the American Heart Association.
“Because diabetic retinopathy is more common in patients with uncontrollable diabetes, and diabetic retinopathy increases the risk of having a stroke, it is important for patients to maintain good control of their diabetes.”

“This research raises the question of whether there is a specific vascular disease pathogenesis in patients with diabetic stroke. Currently, we do not have ongoing follow-up studies, but we are interested in proposing a prospective observational trial in stroke patients with baseline diabetic retinopathy to determine the most common mechanism of stroke in these patients, which would have important implications for prevention efforts.”

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