Retinal arterioles share similar characteristics with cerebral arterioles. The relationship between alteration of the retinal circulation and cerebrovascular disease, its etiopathogenic classification and correlation with conventional vascular risk factors were investigated.

100 patients who presented a first ischemic stroke event between August 2016 and July 2018 were included in this descriptive study. The assigned ophthalmologist assessed alterations in the blood retinal vessels through indirect ophthalmoscopy and classified the degree of involvement.

Retinopathy was noticed in 54 patients from a total of 100 (48 women and 52 men, median age 70 +/- 13.6 years). 46 patients with retinopathy had grade 1, 3 grade 2 retinopathy and 5 grade 3 retinopathy. The distribution of ischemic stroke etiologic subtypes was made through TOAST classification, 36% of strokes were atherothrombotic, 24.4% lacunar and 23.4% indeterminate. In patients with retinopathy, the most significant etiological subtypes were 40% undetermined and 40% atherothrombotic. The most prevalent vascular risk factors were arterial hypertension (81%), smoking (31%) and type 2 diabetes (24%). Four patients with retinopathy did not show associated risk factors (7.4%).

An association was observed between the alteration of the retinal microvasculature and the first event of ischemic stroke. In our population, we found cases of retinopathy in the absence of conventional vascular risk factors. We suggest the value of complementary use of ophthalmoscopy, as a predictor of stroke risk.  Future studies would be necessary to define retinopathy as an independent risk factor for stroke.