Abstract: 【Abstract】 Objective To explore the correlation between fundus changes and the risk of cerebral stroke. Design Case-control study. Participants  450 patients with cerebral stroke, derived from Beijing Tongren Hospital and Beijing Tiantan Hospital, with mean age of（63.6±10.2） years old. 566 subjects without stroke were selected from Beijing Eye Study, with mean age of(62.5±8.7) years old. Methods All subjects had undertaken 45-degree fundus photography. Two ophthalmologists evaluated those fundus photographs to find out the changes of fundus indicators. Logistic regression was used to analyze the correlation between fundus changes and stroke. Orange 2 analysis software was used to visualize the data results. Main Outcome Measures The component ratio of retinal nerve fiber layer defect (RNFLD), retinal arterial narrowing, arteriovenous nicking, vein dilatation, retinopathy (cotton wool spot, and retinal hemorrhage), optic nerve changes and macular diseases and OR value of correlating to stroke. Results  The percentage of retinal arterial narrowing was 46.3% in non-stroke group and 65.1% in stroke group (P<0.05). The percentage of retinal vein dilation was 12.5% in non-stroke group and 38.0% in stroke group (P<0.05). The percentage of RNFLD was 12.7% in non-stroke group and 38.0% in stroke group (P<0.05). The percentage of retinal cotton wool spot was 1.6% in non-stroke group and 4.4% in stroke group (P<0.05). The percentage of retinal hemorrhage was 4.6% in non-stroke group and 11.3% in stroke group (P<0.05). The percentage of optic disc changes was 7.1% in non-stroke group and 16.9% in stroke group (P<0.05). The percent age of macular diseases was 6.4% in non-stroke group and 13.1% in stroke group (P<0.05). Logistic regression analysis showed that RNFLD (OR=4.163, 95%CI 2.792-6.208) and retinal vein dilatation (OR=3.443, 95%CI 2.333-5.082) highly correlated with stroke significantly. Gender had negative correlation with stroke (males were more susceptible to stroke than females). RNFLD and retinal vein dilatation, macular diseases had positive correlation with stroke. Fundus indicators of retinal arterial narrowing, vein dilatation and RNFLD coexisting are most correlated with high risk of stroke. Conclusions Coexisting of RNFLD, retinal arterial narrowing and vein dilatation highly correlate to cerebral stroke.  Evaluation of the retinal circulation and nerve fiber layer defect in vivo maybe offer a simple method to screening cerebrovascular diseases. (Ophthalmol CHN, 2015, 24: 13-18)

Key words: retinal microvascular abnormalities, retinal nerve fiber layer, stroke