Failing eyesight could be warning sign of stroke or heart attack

By Mark Waghorn via SWNS

Failing eyesight can be a warning sign of a stroke or heart attack, according to new research.

People with a form of age-related macular degeneration (AMD) are more likely to develop cardiovascular disease.

The discovery offers hope of a screening program - that starts at the high street opticians.

Lead author Professor Theodore Smith, of Mount Sinai School of Medicine in New York, said: "For the first time, we have been able to connect specific high-risk cardiovascular diseases to a specific form of AMD, the one with subretinal drusenoid deposits (SDDs)."

They are made up of fatty lipids that form beneath light-sensitive retina cells at the back of the eye.

As a result, they are associated with vision loss. Detection is difficult - requiring high-tech imaging scans.

Smith said: "This study is the first strong link between the leading cause of blindness, AMD, and heart disease, the leading cause of death worldwide.

"Furthermore, we also have strong evidence for what actually happens.

"The blood supply to the eye is directly diminished by these diseases, either by heart damage that diminishes blood supply throughout the body or from a blocked carotid artery that directly impedes blood flow to the eye."

Vision loss can be caused by poor circulation resulting from heart disease. It can be a manifestation of an underlying vascular condition.

The finding has important public health implications - opening the door to widescale screening at the population level.

Smith said: "A poor blood supply can cause damage to any part of the body, and with these specific diseases, the destroyed retina and leftover SDDs are that damage. Retinal damage means vision loss, and can lead to blindness."

The study in the journal BMJ Open Ophthalmology is the first to identify high-risk cardiovascular diseases linked to an eye disorder.

It could prompt increased screening to save vision, diagnose undetected heart disease and prevent strokes and heart attacks.

AMD is the leading cause of blindness in those over age 65. It results from damage to the central area of the retina called the macula - responsible for reading and driving vision.

SDDs contain cholesterol and form above a part of the retina called the retinal pigment epithelium (RPE). There is no known treatment for SDDs.

An analysis of 200 AMD patients with severe cardiovascular diseases and stroke found they were nine times more likely to have SDDs.

Co-author Dr. Richard Rosen, chief of the Retina Service for the Mount Sinai Health System, said: "This work demonstrates the fact ophthalmologists may be the first physicians to detect systemic disease, especially in asymptomatic patients.

"Detecting SDDs in the retina should trigger a referral to the individual's primary care provider, especially if no previous cardiologist has been involved. It could prevent a life-threatening cardiac event."

It is estimated around 40,000 Britons develop AMD in the UK each year. It is a debilitating condition that affects everyday activities.

Dr. Jagat Narula, director of the Cardiovascular Imaging Program at Mount Sinai, added: "This study has opened the door to further productive multidisciplinary collaboration between the Ophthalmology, Cardiology and Neurology services.

"We should also focus on defining the disease severity by vascular imaging in cardiology and neurology clinics, and assess their impact on AMD and SDDs with retinal imaging.

"In this way, we can learn which vascular patients should be referred for detection and prevention of blinding disease."