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Published on: March 26, 2020
The Role of Retinal Vascular Density as a Screening Tool for Ageing and Stroke
Andrea Sprödhuber1, Johannes Wolz1, Attila Budai2
1Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Insights
Retinal vascular density (RVD) is significantly lower in stroke patients compared to controls. Age, stroke, diabetes, and hypertension are key factors associated with decreased RVD.
Area of Science:
- Ophthalmology
- Neurology
- Medical Imaging
Background:
- Retinal vascular density (RVD) is a measurable parameter from fundus photographs.
- Cerebrovascular events like stroke may impact retinal vasculature.
Purpose of the Study:
- To quantify RVD in recent stroke patients versus age-matched controls.
- To determine if RVD can serve as a quantitative marker for cerebrovascular events.
Main Methods:
- Analysis of digitized fundus photographs from 158 stroke patients and 1,250 controls.
- Computer-aided image analysis to measure RVD around the optic disk.
- Consideration of age, sex, hypertension, and diabetes as cofactors.
Main Results:
- RVD naturally decreases with distance from the optic disk and with age.
- Stroke patients exhibited a significant 15% reduction in RVD compared to controls.
- Stroke patients with hypertension (older subjects) or diabetes (middle-aged subjects) showed further significant RVD decrease.
Conclusions:
- Age and stroke are significant independent risk factors for reduced RVD.
- Diabetes and hypertension exacerbate the decrease in RVD in stroke patients.
Objectives:
To measure the density of retinal vessels from digitized fundus photographs in patients with recent stroke and age-matched controls. To investigate whether the parameter retinal vascular density (RVD) served as a quantitative marker for cerebrovascular events.
Methods:
Digitized fundus photographs of n = 158 subjects with stroke or transient ischemic attack within 1 year at the time of examination and n = 1,250 age-matched controls without any remarkable medical history were examined. Sex, hypertension, and diabetes were considered to be cofactors. Measurement of RVD was performed with a computer-aided image-analyzing program by segmenting automatically all visible retinal vessels and measuring areas of vessels in distinct circles around the optic disk.
Results:
In controls RVD dwindles with increasing distance from the optic disk. RVD decreased significantly with age (p = 0.000). Stroke patients showed significantly lower values of RVD of -15% in comparison to age-matched controls. In old subjects, stroke in combination with hypertension is associated with a significant decreased RVD, and in middle-aged subjects diabetes and stroke are associated with a significant decreased RVD (p = 0.01).
Conclusion:
Age and stroke are significant risk factors for decreased RVD. Diabetes and arterial hypertension are additional significant risk factors in patients with stroke with respect to RVD.
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