We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

The Retina as a Window to the Brain

Baljean Dhillon, FRCS; Neena Dhillon
Arch Neurol. 2008;65(11):1547-1548. doi:10.1001/archneur.65.11.1547.
Text Size: A A A
Published online


We read with interest the article titled “Seven-Tesla Magnetic Resonance Imaging: New Vision of Microvascular Abnormalities in Multiple Sclerosis” by Ge et al.1 We commend the authors for reporting these novel findings, which may have relevance to microvascular signs observed in the retina.

It would be useful for Ge and colleagues to describe the retinal neurovascular appearances for the 2 patients. If retinal venular abnormalities were noted, we would suggest that they are an accessible and cost-effective marker of neurovascular dysfunction. Peripheral retinal vascular sheathing is a well-recognized feature of multiple sclerosis (MS) and may be overlooked during the neurological examination in MS. Similarities to the findings by Ge and colleagues might suggest a shared vascular pathogenesis between the eye and the brain in MS. Insights into MS pathogenesis may be revealed from closer retinal inspection and image analysis of retinal vasculature.2 These may complement cranial magnetic resonance imaging (MRI) studies in elucidating the natural history and the neurovascular and retinal clinical correlates of vascular changes in MS. Optical coherence tomography, a noninvasive imaging tool, and brain imaging by MRI using SIENA-X (http://www.fmrib.ox.ac.uk/fsl) have demonstrated an association between retinal nerve fiber layer thickness and brain parenchymal fraction.3 Extending the link between brain and retinal vasculature might be achieved by using wide-field retinal imaging with fluorescein angiography in tracking subclinical retinal vascular endothelial dysfunction.4


brain ; retina

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





November 10, 2008
Yulin Ge, MD; Robert I. Grossman, MD
Arch Neurol. 2008;65(11):1548. doi:10.1001/archneur.65.11.1548-a.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
Clarifying Your Question

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
Three Examples of Question Clarification