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Retinal vascular abnormalities in patients with cerebral amyloid angiopathy
Andrew Lee1, Adam Rudkin, Marc Agzarian
1Department of Cerebrovascular Neurology, Flinders Medical Centre, Bedford Drive, Bedford Park, S.A. 5042, Australia.
Insights
Ophthalmology findings in cerebral amyloid angiopathy (CAA) patients revealed microaneurysms and dot-blot hemorrhages. These retinal changes mirror CAA
Area of Science:
- Ophthalmology
- Neurology
- Vascular Medicine
Background:
- Cerebral amyloid angiopathy (CAA) is a significant cause of spontaneous lobar hemorrhage.
- Ophthalmologic manifestations of CAA are not well-documented.
Observation:
- This study examined 7 consecutive patients with CAA-related hemorrhage.
- Ophthalmologic assessments included fundus photography and fluorescein angiography.
Findings:
- All patients exhibited bilateral, multiple dot and blot hemorrhages.
- Multiple microaneurysms were consistently observed on fundus fluorescein angiography.
- Retinal microaneurysms and hemorrhages correlate with CAA histopathology.
Implications:
- Retinal findings may serve as a non-invasive indicator of cerebral amyloid angiopathy.
- Further research could elucidate the natural history of CAA through ocular examination.
- This study highlights the potential for ophthalmology to contribute to the understanding of cerebrovascular diseases.
Objective:
To describe the ophthalmology findings in patients with cerebral amyloid angiopathy (CAA).
Methods:
Data source and subjects: 7 consecutive patients admitted to a tertiary stroke unit with CAA-related hemorrhage, confirmed on magnetic resonance brain imaging gradient echo sequences by 2 independent neuroradiologists.
Design:
case series. Measurements and data analysis: fundus colored photographs and fundus fluorescein angiography.
Results:
All patients showed bilateral multiple dot and blot hemorrhages as well as multiple microaneurysms on fundus fluorescein angiography.
Conclusion:
Microaneurysms and dot and blot hemorrhages funduscopically mirror the histopathology of CAA. This case series is the first to describe retinal vessel changes in CAA and, if confirmed in larger population studies, has the potential to provide insights into the natural history of CAA.
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