Purpose: To describe the 10-year incidence of retinal emboli, the associated risk factors, and the relationship of retinal emboli to stroke and ischemic heart disease mortality.
Methods: The Beaver Dam Eye Study (n = 4,926) is a population-based study of persons 43 to 86 years of age. Retinal emboli were detected at baseline (1988-1990) and at a 5-year (1993-1995) and a 10-year (1998-2000) follow-up by grading of stereoscopic 30 degrees color fundus photographs using standardized protocols. Cause-specific mortality was determined from death certificates.
Results: The 10-year cumulative incidence of retinal emboli was 1.5%. While adjusting for age and sex, the incidence of retinal emboli was associated with increased pulse pressure (odds ratio [OR] 4th versus 1st quartile range, 2.42; 95% confidence interval (CI), 0.98-5.97; P test of trend = .03), higher serum total cholesterol (OR, 2.77; 95% CI, 1.06-7.23; P = .03), higher leukocyte count (OR, 2.28; 95% CI, 1.04-4.96; P = .05), smoking status (OR current versus never smoker, 4.60: 95% CI, 2.08-10.16; P < .001), and a history of coronary artery bypass surgery (OR, 7.17; 95% CI, 3.18-16.18; P < .001) at baseline. While controlling for age, sex, and systemic factors, a significantly higher hazard of dying with a mention of stroke on the death certificate was found in people with retinal emboli (hazard ratio, 2.40; 95% CI, 1.16-4.99) compared with those without.
Conclusions: The data show an association of smoking and cardiovascular disease with the incidence of retinal emboli. Also, persons with retinal emboli are at increased risk of stroke-related death.