Visual Impairment and Major Eye Diseases in Stroke: The National Health and Nutrition Examination Survey, 2005-2008

Purpose: Major ocular diseases share common risk factors and pathogeneses with stroke. This study aimed to evaluate the relation between stroke and the prevalence of ocular diseases including visual impairment (VI) in the United States. Design: Cross-sectional study. Methods: We investigated the prevalence and associations of VI and major eye diseases with stroke among 4570 participants aged 40 years or older in the 2005-2008 National Health and Nutrition Examination Survey (NHANES). The association of VI and major ocular diseases with stroke were estimated using univariate and multivariate logistic regression crude models and models adjusted for demographics and other clinical measurements factors. We also conducted stratified analyses by diabetes and hypertension status. Results: Among the 207 participants with stroke, the mean (SD) age was 67.34 (11.90) years, 59.5% were women (n=102), and 79.7% were non-Hispanic White (n=127). Major eye diseases were all risk factors for stroke, and the odds ratios (ORs) for mild and MSVI were 3.06 (95% confidence interval (CI): 2.02-4.64) and 2.16 (95% CI: 1.21-3.83), respectively. Any ocular disease was a risk factor for stroke with OR 4.46 (95% CI: 2.71-7.37), and the OR for other major eye diseases were as followed: DR, 3.44 (95%m CI: 1.84-6.45); cataract, 4.53 (95% CI: 2.75-7.46); AMD, 3.67 (95% CI: 2.29-5.89), and glaucoma, 2.7 (95% CI: 1.41-5.15) (all P <0.05). After multivariable adjustment, the associations were limited to only mild VI (OR=2.13, 95% CI: 1.32-3.43), AMD (OR=1.99, 95% CI: 1.18-3.34), and any ocular diseases (OR=1.88, 95% CI: 1.12-3.15) (all P <0.05). Significant associations between stroke and any ocular disease and DR were observed among diabetic participants, and significant relation between stroke and MSVI was found among hypertension patients. Conclusions: This sample of the US population demonstrates high prevalence and significant associations between VI and major ocular disease with stroke, which highlights the importance of ocular screening among stroke patients and potential common pathogeneses underlying these conditions. Funding: This study was supported by The Capital Health Research and Development of Special (2020-1-2052); Science & Technology Project of Beijing Municipal Science & Technology Commission (Z181100001818003); the Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20150201) Declaration of Interest: The authors declare no conflicts of interest.