Background: Diabetic retinopathy (DR) is linked to cerebrovascular disease. However, the extent to which DR may confer the risk of incidence stroke is unclear.

Research Design and Methods: This study included two sets. Firstly, a prospective cohort set was performed to explore the relationship of proliferative diabetic retinopathy (PDR) to silent cerebral infarction (SCI). Then an accumulated evidence from cohort studies were evaluated to calculate adjusted hazard ratios of stroke events.

Results: During an average of 5.3 years follow-up, 39 (26 in PDR group and 13 in NDR group) SCI events occurred. After adjusted by covariates, the risk of SCI was significantly higher in the PDR group compared with NDR group (HR=2.69, 95% CI 1.24-5.84). Accumulated evidence from seven cohort studies with 20243 diabetic patients showed that DR was significantly associated with a higher risk of stroke (HR=1.73, 95% CI 1.30-2.16), even after adjusted by covariates (HR=1.54, 95% CI 1.14-1.93). Mild DR, macular edema and cotton wool spots in retina also conferred risk of stroke. There was an explainable low heterogeneity and no evidence of publication bias.

Conclusions: Different signs of DR predict incidence of asymptomatic and symptomatic stroke. Regular retinal examination has important clinical implications for the prevention of stroke in diabetic patients.
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Disclosure

J. Zhou: None. R. Zhang: None. X. Zhu: None. J. Yang: None.

Funding

National Natural Science Foundation of China (81870556, 81670738)

© 2019 by the American Diabetes Association.
2019
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