Retinal microvascular abnormalities and subclinical magnetic resonance imaging brain infarct: a prospective study

Area of Science:

• Neurology
• Ophthalmology
• Vascular Biology

Background:

• Silent brain infarcts and white matter lesions are common radiological findings linked to stroke and dementia risk.
• Understanding the pathophysiology and risk factors for these brain changes remains limited.

Purpose of the Study:

• To investigate if retinal microvascular abnormalities can predict the risk of brain infarcts and white matter lesions.
• To explore the prognostic value of retinal vascular imaging in subclinical cerebrovascular disease.

Main Methods:

• A prospective, population-based study of 810 middle-aged individuals without prior stroke or MRI infarct.
• Baseline and follow-up MRI brain examinations and retinal photography over approximately 10.5 years.
• Standardized grading of MRI for infarcts and white matter lesions, and retinal photographs for microvascular abnormalities.

Main Results:

• Retinopathy was associated with incident cerebral infarct (OR 2.82) and lacunar infarct (OR 3.19).
• Retinal arteriovenous nicking correlated with incident cerebral infarct (OR 2.82), lacunar infarct (OR 2.48), and white matter lesion incidence/progression (ORs 2.12-2.22).
• These associations remained significant after adjusting for cardiovascular risk factors.

Conclusions:

• Retinal microvascular abnormalities are independently associated with the development and progression of subclinical brain infarcts and white matter lesions.
• Retinal vascular imaging serves as a potential non-invasive tool for assessing cerebral small-vessel disease.
• Findings highlight the link between retinal and cerebral microvascular health.