Retinal microvascular abnormalities and their relationship with hypertension, cardiovascular disease, and mortality

Retinal microvascular abnormalities, such as generalized and focal arteriol ar narrowing, arteriovenous nicking and retinopathy, reflect cumulative vas cular damage from hypertension, aging, and other processes. Epidemiological studies indicate that these abnormalities can be observed in 2-5% of the n ondiabetic general population and are strongly and consistently associated with elevated blood pressure. Generalized arteriolar narrowing and arteriov enous nicking also appear to be irreversible long-term markers of hypertens ion, related not only to current but past blood pressure levels as well. Th ere are data supporting an association between retinal microvascular abnorm alities and stroke, but there is no convincing evidence of an independent o r direct association with atherosclerosis, ischemic heart disease, or cardi ovascular mortality. New computer-related imaging methods are currently bei ng developed to detect the presence and severity of retinal arteriolar narr owing and other microvascular characteristics. When reliably quantified, re tinal microvascular abnormalities may be useful as risk indicators for cere brovascular diseases. (Surv Ophthalmol 46:59-80, 2001. (C) 2001 by Elsevier Science Inc. All rights reserved.).