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Looking into the eye...and

seeing a future stroke

About 600,000 people in the U.S. suffer a stroke each year. Despite medicine’s best efforts,

many of those who survive are left with permanent disability. Prevention, then,

remains the best defense against this devastating disease. To that end, doctors

have long tried to identify persons who need preventive treatment. But making

accurate predictions based on the presence of stroke risk factors, such as high

blood pressure (hypertension) or diabetes, is nearly impossible. A new study

holds out hope that doctors may soon be able to tell whether patients are

heading for a stroke, simply by looking in their eyes.

Picturing trouble

Investigators photographed the retinas of more

than 10,000 men and women who were part of a large study looking at

atherosclerosis risk in U.S. communities. The retina is a delicate light-sensitive layer of

tissue at the back of the eye. The tiny blood vessels that nourish the retina

are easily injured. Atherosclerosis, diabetes, and hypertension are among the

conditions that can cause retinal damage. Vessels in the retina may grow

abnormally, become fragile, bleed (hemorrhage), or develop other changes that

may not be visible during a dilated eye exam.

The photographs taken during the study were

digitized and analyzed by a special computer. During the next 3 1/2 years,

those people whose photos showed certain types of blood vessel injury had a far

higher rate of stroke than those with healthy vessels. This could not be

explained by the presence of other risk factors, which were taken into

consideration. Even people who would not normally be thought of as having a

high risk of stroke were in danger if they had some of those eye changes.

The technology used in this study is still

experimental and not routinely available. The investigators hope, however, that

if additional studies reach similar conclusions, retinal photography could

become a useful tool for estimating stroke risk.

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