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Relationship of ocular microcirculation, measured by laser speckle flowgraphy, and silent brain infarction in primary
Hiroshi Kunikata1, Naoko Aizawa2, Masataka Kudo3
1Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan.
Insights
Primary aldosteronism patients with silent brain infarction were older and had lower blowout time (BOT). Age is a risk factor, while BOT is protective, suggesting BOT can predict silent brain infarction in primary aldosteronism.
Area of Science:
- Cardiology
- Neurology
- Ophthalmology
Background:
- Primary aldosteronism (PA) patients face higher cerebro- and cardiovascular event (CVE) risks than essential hypertension (EH) patients.
- Silent brain infarction (SBI) is a known risk factor and predictor for CVEs.
Purpose of the Study:
- To investigate the relationship between laser speckle flowgraphy (LSFG) findings and the occurrence of SBI in PA patients.
- To evaluate mean blur rate (MBR) as a biomarker for ocular blood flow in relation to SBI.
Main Methods:
- 87 PA patients without prior symptomatic cerebral events were studied.
- Mean blur rate (MBR) in the optic nerve head (ONH) was measured using LSFG.
- SBI occurrence was assessed via magnetic resonance imaging, analyzing MBR waveform variables (skew, blowout score, blowout time) and clinical data.
Main Results:
- 17% of PA patients had SBI.
- SBI patients were significantly older and had significantly lower blowout time (BOT) in the ONH capillary area.
- Age and BOT were identified as independent factors for SBI presence in PA patients.
Conclusions:
- PA patients with SBI exhibit older age and reduced MBR BOT compared to those without SBI.
- Age emerged as a risk factor, while BOT acted as a protective factor for SBI in PA.
- BOT, an objective, non-invasive biomarker, shows potential for predicting SBI in PA evaluations.
Purpose:
Recent studies have shown that the risk of cerebro- and cardiovascular events (CVEs) is higher in patients with primary aldosteronism (PA) than in those with essential hypertension (EH), and that silent brain infarction (SBI) is a risk factor and predictor of CVEs. Here, we evaluated the relationship between findings from laser speckle flowgraphy (LSFG), a recently introduced non-invasive means of measuring mean blur rate (MBR), an important biomarker of ocular blood flow, and the occurrence of SBI in patients with PA.
Methods:
87 PA patients without symptomatic cerebral events (mean 55.1 ± 11.2 years old, 48 male and 39 female) were enrolled in this study. We measured MBR in the optic nerve head (ONH) with LSFG and checked the occurrence of SBI with magnetic resonance imaging. We examined three MBR waveform variables: skew, blowout score (BOS) and blowout time (BOT). We also recorded clinical findings, including age, blood pressure, and plasma aldosterone concentration.
Results:
PA patients with SBI (15 of 87 patients; 17%) were significantly older and had significantly lower BOT in the capillary area of the ONH than the patients without SBI (P = 0.02 and P = 0.03, respectively). Multiple logistic regression analysis revealed that age and BOT were independent factors for the presence of SBI in PA patients (OR, 1.15, 95% CI 1.01-1.38; P = .03 and OR, 0.73, 95% CI 0.45-0.99; P = .04, respectively).
Conclusion:
PA patients with SBI were older and had lower MBR BOT than those without SBI. Our analysis showed that age was a risk factor for SBI, and that BOT was a protective factor, in patients with PA. This suggests that BOT, a non-invasive and objective biomarker, may be a useful predictor of SBI and form part of future PA evaluations and clinical decision-making.
