Ten-year incidence of retinal emboli in an older population

Background and Purpose - To assess 10-year incidence of retinal emboli and its predictors in an older population. Methods - Survivors of 3654 Blue Mountains Eye Study participants ≥49 years of age were re-examined 5 and 10 years later. Incident emboli were assessed from retinal photographs. Results - Cumulative 10-year incidence was 2.9% (95% CI, 2.1% to 3.6%) among 2361 at risk. Age was associated with incident emboli (P_trend=0.0001). After multivariate adjustment, hypertension (odds ratio [OR], 1.8; CI, 1.0 to 3.1), hypercholesterolemia (OR, 1.3; CI, 1.0 to 1.6), overweight (OR, 3.3; CI, 1.6 to 6.9), current smoking (OR, 2.5; CI, 1.1 to 5.9), increasing fibrinogen level (OR per mg/dL, 1.1; CI, 1.0 to 1.2), and retinal vascular signs (arteriovenous nicking OR, 2.0; CI, 1.2 to 3.6; arteriolar wall opacification OR, 2.3; CI, 1.1 to 5.0; retinal vein occlusion OR, 3.2; CI, 1.0 to 9.9) were significantly associated with incident emboli. Conclusions - The 3% incidence of retinal arteriolar emboli found in this older population is likely to be an underestimate attributable to the transient nature of emboli and differential loss to follow-up. Most cardiovascular risk factors predict retinal embolism.