Evaluating Ischemic Stroke Subtypes: Does the Retinal Microvasculature Hold Clues to What Lies Beneath?

To the Editor:We read with great interest the article entitled ‘Retinopathy in ischemic stroke subtypes’1 appearing in Stroke , and would like to congratulate the authors for this novel effort. Doubal et al hypothesized that there would be higher rates of retinopathy in patients with acute lacunar infarcts but failed to demonstrate any significant correlation. We have reason to suggest that it may be due to the basis of their hypothesis. Doubal et al essentially believe that retinopathy and lacunar infarcts are both, by large, manifestations of disordered small vessel endothelium and an increased permeability in the blood-retinal or blood-brain barrier.Our knowledge …