Brief Reports Associations of Retinal Microvascular Signs and Intracranial Large Artery Disease

Background and Purpose—Intracranial large artery disease (ICLAD) is a major cause of ischemic stroke. Retinal microvascular changes are associated with stroke, including small vessel cerebral disease and extracranial carotid disease. We examined the relationship between ICLAD and retinal microvascular changes. Methods—This is a prospective cohort of 802 acute ischemic stroke patients. Retinal changes were assessed from photographs by graders masked to clinical data. ICLAD was evaluated using prespecified criteria. Results—ICLAD was not associated with ipsilateral retinal arteriolar/venular caliber, focal arteriolar narrowing, or arteriovenous nicking. Severe enhanced arteriolar light reflex was independently associated with any ICLAD (P0.006) and severe ICLAD (P0.001). Conclusion—Enhanced arteriolar light reflex, but not retinal vessel caliber, was related to ICLAD. These data suggest that retinal microvascular signs have specific associations with large cerebral vessel disease. (Stroke. 2011;42:812-814.) Key Words: intracranial large artery disease retina stroke Intracranial large artery disease (ICLAD) is the mostcommon cause of stroke in Asians.1 Retinal and cerebral microvessels share common embryological origins and arte-rial supply, and they are end-arteries without anastomoses. In the Multi-Centre Retina and Stroke study, retinal microvas