Reduced Retinal Microvascular Perfusion in Patients With Stroke Detected by Optical Coherence Tomography Angiography

Area of Science:

• Ophthalmology
• Neurology
• Medical Imaging

Background:

• Stroke is a leading cause of death and disability, particularly in aging populations.
• There is a critical need for novel biomarkers for stroke detection and monitoring.
• The retina provides an accessible window to study microvasculature in vivo, but its link to stroke is not fully understood.

Purpose of the Study:

• To investigate retinal microvascular characteristics in patients with stroke.
• To determine if retinal vessel density (VD) differs between stroke patients and controls.
• To explore the potential of optical coherence tomography angiography (OCTA) parameters as stroke biomarkers.

Main Methods:

• Recruited 189 stroke patients and 195 age-matched controls from a tertiary hospital in China.
• Measured macular VD in superficial and deep capillary plexuses (SCP & DCP), foveal avascular zone (FAZ) metrics, and optic disc VD using OCTA.
• Adjusted for traditional stroke risk factors including age, sex, blood pressure, smoking, HbA1c, cholesterol, and HDL.

Main Results:

• Macular VD in SCP and DCP was significantly decreased in stroke patients across all sectors.
• Stroke patients exhibited lower VD around the FAZ and at the optic disc.
• Parafovea-superior-hemi VD of DCP > 54.53% was identified as a protective factor against stroke (OR: 0.169).

Conclusions:

• Retinal VD is reduced in stroke patients, independent of conventional stroke risk factors.
• OCTA parameters, including retinal VD, show promise for distinguishing stroke patients with high accuracy (AUC: 0.962).
• Retinal microvascular assessment may offer a novel approach for stroke monitoring.