Study of Changes in Small Arteries of the Retina

The retina is a light-sensitive structure at the back of the eyeball which receives images formed by the lens and transmits them to the brain for recognition of objects. Small arteries (called arteriole) on the retina can be observed by a retinal camera. It is considered that changes in small arteries in the retina are associated with future stroke incidence according to the studies conducted in Japan.

Retinal photography was performed and arteriolar sclerotic (atherosclerosis in arteriole) and hypertensive changes were graded from 0 to IV, based on the criteria developed by Dr. Scheie. The photographs were examined by an experienced physician (one of our co-investigators) in Japan, who is specially trained and experienced in this observational technique.

The results of the present study showed that abnormal hypertensive and arteriolar sclerotic changes (defined as persons with changes > grade II) were positively associated with hypertension and diabetes among Japanese American men and women and native Japanese men and a high ratio of total cholesterol to high-density lipoprotein cholesterol ratio in Japanese American men. No significant associations were observed with smoking status and alcohol consumption. A higher prevalence of hypertensive and arteriolar sclerotic changes in the retinal arterial system were observed among native Japanese men as compared to Japanese American men, despite the fact that Japanese American men have a higher prevalence of hypertension and diabetes, as shown in Chart 5.

The higher prevalence of abnormal changes in the retinal arterial system in native Japanese men is coincided with a higher mortality rate of stroke in the native Japanese population than in the American population Table 1 in Overview>. This may lead to the hypothesis that retinal arteries and cerebral arteries are unfavorably affected by environmental factors among native Japanese and thereby a risk of stroke is elevated among them. This hypothesis can only be tested by comparing three populations: native Japanese, Japanese Americans and Caucasian Americans in our future study. 

Publications and Presentations

Namekata T, Hughes D, Arai C, Moore D, Suzuki K, Mori M, Marcovina S, Perrin E, Hatano S, Hayashi C, Hasegawa M. Arteriolar sclerotic and hypertensive changes in the retinal arterial system and cardiovascular disease risk factors among Japanese Americans. American Journal of Epidemiology 1996; 143(11):S13