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The Eye - window to the soul or a mirror of systemic health? Or:What weight to give retinopathy as a risk factor for IHD
  1. Paul Foster (p.foster{at}
  1. Division of Genetics and Epidemiology, UCL Institute of Ophthalmology, United Kingdom
    1. Kay Tee Khaw (kk101{at}
    1. Clinical Gerontology Unit, United Kingdom


      It has been said that there is no systemic disease which does not have a sign identifiable on ophthalmic examination. For many physicians, retinopathy- microaneurysms, haemorrhages, "hard" lipid exudates, micro-infarcts of the retinal nerve fibre layer (cotton wool spots)- is synonymous with diabetes. A clinically distinct form of retinopathy is also recognised in hypertension, although traditionally, abnormalities of arteriovenous crossing architecture are the sine qua non feature of hypertensive retinopathy, with haemorrhagic and exudative changes only following later. However, population-based research has shown that shown that retinopathy is a relatively common finding in older people without diabetes.(1)

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