Retinal abnormalities in patients with cerebrovascular accident

Abstract

Background: Cerebrovascular accident (CVA) or stroke is a leading cause of morbidity and mortality worldwide. The aim of the study is to document the retinal abnormalities in patients with CVA seen in a tertiary hospital. Materials and Methods: The retina of patients aged ≥18 years with CVA occurring within 1 year managed in a tertiary hospital were examined from October to December 2013 and the findings recorded. Patients with prior history of ocular trauma and unconscious stroke patients were excluded. Data were analyzed with Statistical Package for the Social Sciences (SPSS) version 20 and P < 0.05 was taken as significant. Results: A total of 85 patients comprising 61 (71.8%) males and 24 (28.2%) females were seen. The mean age was 66.1 ± 11.0 years (range: 43-88 years), out of which 57 (67.1%) were ≥60 years. There were 67 (78.8%) and 18 (21.2%) cases of ischemic and hemorrhagic stroke, respectively. Hypertension was the most common predisposing factor of stroke in 95.3% of the patients. Abnormalities in the retina background included hemorrhages in 18 (10.6%) eyes, hard exudates and cotton wool spots in 13 (7.8%) and 4 (2.4%) eyes respectively. Retinal vascular abnormalities were documented in 55 (32.4%) eyes. There were more abnormalities in the retina vasculature of patients with hypertension, diabetes mellitus (DM), and hyperlipidemia than in patients without these conditions (P < 0.50). There were also more abnormalities in the background retina of the diabetics when compared to the nondiabetics (P = 0.02). Conclusion: Regular ophthalmic evaluation of patients with predisposing risk factors for CVA with early detection of ocular manifestations/complications of the disease could help modify treatment to prevent or limit more untoward and debilitating effects such as stroke.