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Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
Optical Coherence Tomography Angiography Reveals Distinct Retinal Structural and Microvascular Abnormalities in
Xiayin Zhang1, Hui Xiao1, Chunxin Liu2
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Insights
Optical coherence tomography angiography (OCTA) reveals specific retinal changes in patients with cerebrovascular disease (CeVD). These findings suggest retinal abnormalities can serve as biomarkers for CeVD risk.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Biology
Background:
- Cerebrovascular disease (CeVD) is a major cause of death and disability worldwide.
- Retinal microangiopathy is increasingly recognized as a reflection of cerebral microangiopathy.
- Early detection and management of CeVD risk factors are crucial.
Purpose of the Study:
- To evaluate retinal structure and microvasculature in CeVD patients using OCTA.
- To identify specific OCTA biomarkers for CeVD.
- To assess the diagnostic accuracy of OCTA in differentiating CeVD patients from healthy controls.
Main Methods:
- A cross-sectional study involving 121 CeVD patients and 44 healthy controls.
- Utilized optical coherence tomography angiography (OCTA) to analyze retinal structure and microvasculature.
- Correlated OCTA parameters with visual acuity and transcranial Doppler findings.
Main Results:
- CeVD patients exhibited significant thinning in the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (GC-IPL).
- Macular microvasculature reduction was observed in all quadrants of CeVD patients.
- Combined structural and microvascular OCTA parameters achieved high diagnostic accuracy (AUC = 0.918) for CeVD detection.
Conclusions:
- OCTA effectively reveals distinct retinal structural and extensive macular microvascular changes in CeVD.
- These retinal abnormalities show potential as valuable biomarkers for managing individuals at high risk of cerebrovascular events.
- OCTA offers a non-invasive method for assessing CeVD-related vascular changes.
Abstract:
Cerebrovascular disease (CeVD) is one of the leading global causes of death and severe disability. To date, retinal microangiopathy has become a reflection of cerebral microangiopathy, mirroring the vascular pathological modifications in vivo. To evaluate the retinal structure and microvasculature in patients with CeVD, we conducted a cross-sectional study in Zhongshan Ophthalmic Center and Department of Neurology of Third Affiliated Hospital, Sun Yat-sen University using optical coherence tomography angiography (OCTA). CeVD patients (n = 121; 238 eyes) and healthy controls (n = 44; 57 eyes) were included in the analysis. The CeVD group showed significant thinning of the peripapillary retinal nerve fiber layer (pRNFL) thickness in the temporal and nasal quadrants, and thinning of the macular ganglion cell-inner plexiform layer (GC-IPL) in the inferior quadrant, while macular microvasculature reduction was prominent in all nine quadrants. There were significant correlations between OCTA parameters, visual acuity, and transcranial doppler parameters in the CeVD group. The specific structural parameters combining microvasculature indices showed the best diagnostic accuracies (AUC = 0.918) to discriminate CeVD group from healthy controls. To conclude, we proved that OCTA reveals specific patterns of retinal structural changes and extensive macular microvascular changes in CeVD. Additionally, these retinal abnormalities could prove useful disease biomarkers in the management of individuals at high risk of debilitating complications from a cerebrovascular event.
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