Ten-year incidence of retinal emboli in an older population

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The prevalence of retinal artery emboli has previously been evaluated in a few studies. The same authors previously reported a 1.4% prevalence of retinal artery emboli in the Australian population. They now report the 10-year incidence of retinal emboli and its predictors in an older population. Survivors of 3654 Blue Mountains Eye Study participants at least 49 years of age were reexamined five and 10 years after inclusion in the study. Incident retinal emboli were assessed from retinal photographs. The authors found that cumulative 10-year incidence was 2.9% (95% CI, 2.1% to 3.6%) among 2361 at risk patients. Age was associated with incident emboli (P trend = .0001). After multivariate adjustment, hypertension (odds ratio [OR], 1.8; CI, 1.0 to 3.1), hypercholesterolemia (OR, 1.3; CI, 1.0 to 1.6), overweight (OR, 3.3; CI, 1.6 to 6.9), current smoking (OR, 2.5; CI, 1.1 to 5.9), increasing fibrinogen level (OR per mg/dL, 1.1; CI, 1.0 to 1.2), and retinal vascular signs (arteriovenous nicking OR, 2.0; CI, 1.2 to 3.6; arteriolar wall opacification OR, 2.3; CI, 1.1 to 5.0; retinal vein occlusion OR, 3.2; CI, 1.0 to 9.9) were significantly associated with incident emboli. The authors conclude that the 3% incidence of retinal arteriolar emboli found in this older population is likely to be an underestimate attributable to the transient nature of emboli and differential loss to follow-up. Most cardiovascular risk factors are associated with retinal embolism.—Valérie Biousse