Choroidal Vascular Volume, White Matter Hyperintensity, and Their Interaction With Cognitive Function in Aging Adults

Area of Science:

• Ophthalmology
• Neurology
• Gerontology

Background:

• The retinal choroid is a potential biomarker for dementia and age-related brain disorders.
• Clinical applications of the choroid as a surrogate marker are underexplored.
• This study investigates links between choroidal perfusion, white matter hyperintensity (WMH), and cognition.

Purpose of the Study:

• To examine associations between choroidal perfusion and WMH.
• To determine the relationship between these factors and cognitive function, particularly memory.
• To explore potential interactions influencing cognitive performance.

Main Methods:

• Quantified WMH severity (volume, shape) and choroidal characteristics (vascular volume, vascularity index, flow density) in aging adults.
• Used partial Spearman correlation to analyze choroidal-WMH metric relationships.
• Employed general linear models and generalized estimating equations to assess cognitive associations and interactions.

Main Results:

• 197 participants included; choroidal vascular volume/index inversely correlated with WMH volumes.
• Irregular WMH shape and reduced choroidal vascular volume linked to poorer memory.
• Significant interaction: WMH effects on memory amplified by lower choroidal perfusion.

Conclusions:

• WMH severity and choroidal perfusion status may jointly predict memory performance, potentially via shared ischemic mechanisms.
• Further research is needed to validate WMH and choroidal metrics for predicting cognitive decline.