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Association between optic disc pallor and lacunar stroke.

Samuel Gibbon1,2, Fergus Doubal1, Francesca Chappell1,3

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Optic disc pallor is linked to lacunar stroke and small vessel disease (SVD) severity in mild stroke patients. This finding highlights the potential of fundus photography in understanding SVD pathology.

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NEUROOPHTHALMOLOGYNEURORADIOLOGYSTROKE

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Area of Science:

  • Ophthalmology
  • Neurology
  • Vascular Medicine

Background:

  • Cerebral small vessel disease (SVD) is a significant contributor to stroke.
  • Optic disc pallor is a potential indicator of underlying vascular damage.
  • Understanding the relationship between optic disc pallor and stroke subtypes is crucial for diagnosis and prognosis.

Purpose of the Study:

  • To investigate the association between optic disc pallor and ischemic stroke subtypes (cortical vs. lacunar).
  • To examine the relationship between optic disc pallor and cerebral small vessel disease (SVD) scores.
  • To evaluate the utility of optic disc pallor as a biomarker in mild stroke patients.

Main Methods:

  • Quantification of optic disc pallor using PallorMetrics software on color fundus photographs.
  • Analysis of 92 patients with cortical stroke and 92 with lacunar stroke.
  • Logistic regression models to assess associations with stroke type and SVD scores, analyzing eyes separately.

Main Results:

  • Increased optic disc pallor was significantly associated with lacunar stroke in the right eye.
  • Optic disc pallor correlated with SVD scores in specific zones of the right eye.
  • Weaker, non-significant trends were observed in the left eye.

Conclusions:

  • Optic disc pallor may serve as an indicator of SVD severity and lacunar stroke.
  • The findings suggest potential vascular damage to the optic nerve or its pathways.
  • Color fundus photography can be a valuable tool for studying SVD pathology.