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Published on: November 6, 2017
Association between retinal vessel density and neuroimaging features and cognitive impairment in cerebral small
Lan Ma1, Meizi Wang2, Huimin Chen2
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Retinal vessel density (RVD) in the deep capillary plexus was lower in patients with moderate/severe cerebral small vessel disease (CSVD). RVD may help predict CSVD burden and neuroimaging features.
Area of Science:
- Ophthalmology
- Neurology
- Medical Imaging
Background:
- Cerebral small vessel disease (CSVD) is a common cause of stroke and cognitive decline.
- Neuroimaging features like white matter hyperintensities, lacunes, microbleeds, and enlarged perivascular spaces are used to assess CSVD burden.
- Retinal vessel density (RVD) is a potential indicator of microvascular changes in the brain.
Purpose of the Study:
- To investigate the associations among retinal vessel density (RVD), neuroimaging features, and cognitive impairment in patients with sporadic CSVD.
- To determine if RVD can serve as a predictive tool for the neuroimaging-based burden of CSVD.
Main Methods:
- Prospective observational study involving 49 patients with CSVD.
- CSVD burden assessed using a 4-point scoring system (white matter hyperintensities, lacunes, microbleeds, basal-ganglia perivascular space).
- Retinal vessel density (RVD) evaluated using optical coherence tomography angiography (OCTA) in superficial and deep retinal capillary plexuses.
Main Results:
- Patients with moderate/severe CSVD burden had significantly lower RVD in the left deep retinal capillary plexus (DRCP) compared to those with none/mild burden.
- RVD in the left DRCP was associated with the overall CSVD burden score, severe white matter hyperintensities, and basal-ganglia perivascular space.
- No significant association was found between RVD in the para-fovea and peri-fovea areas of the left DRCP and cognitive impairment.
Conclusions:
- Retinal vessel density in the left DRCP may reflect the presence of cerebral small vessel lesions.
- RVD in the left DRCP could be a valuable tool for predicting the neuroimaging-based burden of CSVD.
Aims:
This study aimed to investigate the associations among retinal vessel density (RVD), neuroimaging features and cognitive impairment in patients with sporadic cerebral small vessel disease (CSVD).
Methods:
This was a prospective observational study. A total of forty-nine patients with CSVD were recruited. The CSVD imaging burden was calculated by using a scoring system with a total score of 4 that assigns one point each for severe white matter hyperintensities (WMH), lacune, microbleeds (MBs), and basal-ganglia perivascular space (BG-PVS). Patients with a burden score ≥ 2 were classified as having a moderate/severe burden, and those with a score ≤ 1 were classified as the having a none/mild burden. The RVD in the superficial retinal capillary plexus (SRCP) and deep retinal capillary plexus (DRCP) was evaluated by using optical coherence tomography angiography (OCTA). The associations among the RVD values, CSVD imaging features, and cognitive impairment were evaluated.
Results:
Patients with a moderate/severe CSVD burden showed lower RVD values in the para-fovea and peri-fovea areas of the left DRCP than patients with none/mild burden (para-fovea, β coefficient= -0.185 [-0.351~-0.015], P = 0.003; peri-fovea, β coefficient= -0.113 [-0.208~-0.018], P = 0.021). The RVD values in the para-fovea and peri-fovea areas of the left DRCP were significantly associated with the CSVD burden score after adjusting for age and vascular risk factors (P = 0.030 and P = 0.021, respectively) and with severe WMH (para-fovea, R = -0.398, P = 0.005; peri-fovea, R= -0.443, P = 0.001) and BG-PVS (para-fovea, R = -0.445, P = 0.001; peri-fovea, R= -0.396, P = 0.005). Neither para-fovea nor peri-fovea RVD values had a marked association with cognition.
Conclusion:
The RVD in the left DRCP may reflect the presence of cerebral small vessel lesions and might be a useful tool for predicting the neuroimaging-based burden of CSVD.
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