Retinal ischemic perivascular lesions in individuals with systemic vascular ischemia

Aim The aim of this study was to investigate the relationship between systemic vascular ischemia and retinal ischemic perivascular lesions (RIPLs). Patients and methods This is a single-center comparative cross-sectional retrospective observational analytic study that was conducted at a tertiary care eye hospital (Tanta University Hospital, Department of Ophthalmology, Tanta University, Tanta, Egypt). The eligible patients were consecutively recruited into the study, which included 75 eyes of 75 consecutive patients at risk for vascular ischemia, including diabetic patients with a duration exceeding 5 years, hypertensive patients with a similar duration, individuals with a history of retinal vein occlusion in the contralateral eye, stroke patients, and coronary artery disease patients. Additionally, 75 eyes of age-matched and sex-matched controls without vascular ischemia risk were included for comparison. All participants had a complete ophthalmological evaluation including age, sex, anterior segment examination, intraocular pressure measurement, fundus examination, and a spectral-domain optical coherence tomography. Results A notable disparity (greater in the vascular ischemia group) was observed between the two groups regarding hypertension ( P <0.001), diabetes ( P <0.001), stroke ( P =0.001), central retinal vein occlusion in the contralateral eye ( P =0.003), coronary artery disease ( P =0.003), and the incidence of RIPLs ( P <0.001). Age was significantly associated with RIPLs in univariate analysis [odds ratio (OR)=0.94, 95% confidence interval (CI)=0.89–0.99, P =0.027]. Hypertension was strongly linked to RIPLs (OR=4.26, 95% CI=2.3–8.9, P <0.001). In addition, diabetes had a significant correlation with RIPLs (OR=3.19, 95% CI=1.5–6.5, P =0.001). RIPLs were significantly associated with vascular ischemia participation (OR=4.8, 95% CI=2.25–10.4, P <0.001). Conclusion A notable correlation was observed between the coexisting systemic vascular ischemia and RIPLs, which function as anatomical markers of previous retinal ischemic infarcts.