Retinal Vessel Traits May Signal Future Stroke Risk

Retinal vessel tortuosity was associated with an elevated risk of stroke. “Highly tortuous vessels can restrict or occlude blood flow and may also encourage platelet activation and the formation of blood clots, contributing to stroke development,” the researchers wrote. Photo: Leticia Rousso, OD, and Joseph Sowka, OD. Click image to enlarge. A study published in Ophthalmology Science found that retinal imaging could help identify patients at higher risk of cerebrovascular disease.Researchers analyzed baseline and six-year follow-up data from 30,097 adults aged 45 to 85 who were enrolled in the Canadian Longitudinal Study on Aging. Using nonmydriatic fundus photos and a deep learning algorithm designed for retinal vasculature analysis, they measured various components of retinal images, “including arteriolar and venular diameter, area and tortuosity,” according to the paper. They also assessed whether patients had experienced a cerebrovascular stroke. Of the 21,547 participants with acceptable images and follow-up data, 1.2% developed a nonfatal stroke over six years.Larger arteriolar area was associated with 38% higher odds of stroke and larger venular area was linked to 71% higher odds, while wider retinal arterioles at baseline were associated with 16% lower odds. These associations remained significant even with the inclusion of fatal strokes.The researchers also noted in the study that “statistically significant interactions were found between sex and both arteriolar and venular tortuosity,” with greater arteriolar tortuosity associated with stroke in women but not in men, while venular tortuosity showed the opposite association.They concluded that retinal vessel area—an understudied measurement parameter that incorporates both vessel width and length—“may help to develop stroke prediction models in the future,” adding on that more work is needed to clarify the biological significance and timing of retinal vascular changes before these measures can be incorporated into risk assessment tools.Click here for the journal source. O’Neil A, Welikala RA, Barman S, et al. Retinal vessel traits and the risk of stroke: the Canadian longitudinal study on aging. Ophthalmol Sci. June 23, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.