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Retinal Microvascular Changes in Subtypes of Ischemic Stroke.

Ying Zhao1,2, Bing Yang1,2, An-Ding Xu1,2

  • 1Department of Neurology and Stroke Center, The First Affiliated Hospital, Jinan University, Guangzhou, China.

Frontiers in Neurology
|February 15, 2021
PubMed
Summary

Retinal microvascular diameter may indicate specific ischemic stroke types. Wider venular diameter (MVD) is linked to atherothrombosis (AT) stroke, suggesting a potential diagnostic marker.

Keywords:
ischemic strokeneurolucidaretinal microvascular changessubtypesvenular diameter

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Area of Science:

  • Ophthalmology
  • Neurology
  • Vascular Biology

Background:

  • The brain and retinal microvasculature share similarities.
  • Understanding these similarities can aid in diagnosing cerebrovascular diseases.

Purpose of the Study:

  • To investigate the association between retinal microvasculature parameters and ischemic stroke subtypes.
  • To determine if retinal imaging can help differentiate between atherothrombosis (AT), small artery disease (SAD), and cardioembolism (CE) stroke.

Main Methods:

  • 141 ischemic stroke patients were classified into AT, SAD, or CE subtypes using the NEW-TOAST criteria.
  • Digital fundus photographs were analyzed for retinal vasculature parameters, including mean venular diameter (MVD) and arteriovenous ratio (MAVR).
  • Statistical analysis, including receiver operating characteristic (ROC) curve analysis, was performed.

Main Results:

  • Patients with AT stroke had a significantly wider mean venular diameter (MVD) compared to SAD and CE subtypes (P=0.047).
  • CE subtype patients showed a higher mean arteriovenous ratio (MAVR) (P=0.010), while SAD patients exhibited greater venular tortuosity (P=0.024).
  • MVD within 0.5-1.0 disk diameter (MVD0.5-1.0DD) predicted the AT subtype with 61.1% sensitivity and 73.3% specificity (cutoff: 82.23 μm).

Conclusions:

  • Retinal MVD0.5-1.0DD may serve as a potential indicator for the atherothrombosis (AT) stroke subtype.
  • Further large-scale prospective studies are required to elucidate the underlying mechanisms and establish causality.