Alterations of optic tract and retinal structure in patients after thalamic stroke

Abstract

ObjectivesTo investigate the association between degeneration of retinal structure and shrinkage of the optic tract in patients after thalamic stroke.Materials and methodsPatients with unilateral thalamic stroke were included. Structural magnetic resonance imaging (MRI) and optical coherence tomography (OCT) were performed to obtain parameters of optic tract shrinkage (lateral index) and retina structural thickness (retinal nerve fiber layer, RNFL; peripapillary retinal nerve fiber layer, pRNFL; ganglion cell-inner plexiform layer, GCIP), respectively. Visual acuity (VA) examination under illumination was conducted using Snellen charts and then converted to the logarithm of the minimum angle of resolution (LogMAR). We investigated the association between LI and OCT parameters and their relationships with VA.ResultsA total of 33 patients and 23 age-sex matched stroke-free healthy controls were enrolled. Patients with thalamic stroke showed altered LI compared with control participants (P = 0.011) and a significantly increased value of LI in the subgroup of disease duration more than 6 months (P = 0.004). In these patients, LI were significantly associated with pRNFL thickness (β = 0.349, 95% confidence interval [CI]: 0.134–0.564, P = 0.002) after adjusting for confounders (age, sex, hypertension, diabetes, dyslipidemia, and lesion volume). LI and pRNFL were both significantly associated with VA in all patients (LI: β = −0.275, 95% CI: −0.539 to −0.011, P = 0.041; pRNFL: β = −0.023, 95% CI: −0.046 to −0.001, P = 0.040) and in subgroup of disease duration more than 6 months (LI: β = −0.290, 95% CI: −0.469 to −0.111, P = 0.002; pRNFL: β = −0.041, 95% CI: −0.065 to −0.017, P = 0.003).ConclusionShrinkage of the optic tract can be detected in patients with thalamic stroke, especially after 6 months of stroke onset. In these patients, the extent of optic tract atrophy is associated with pRNFL thickness, and they are both related to visual acuity changes.

Linked Distinct Multi-modular Brain Connectivity Patterns with Retina Microvascular and Structural Alterations, and Their Correlations with Visual Performance in Thalamic Stroke

“…Owing to its connection with the thalamus and the fact that it can be non-invasively visualized, the retina is suggested to provide important information on brain pathology [18,19]; and we assume that it could be a future target of imaging in thalamic stroke. Indeed, our previous reports have shown thalamic stroke patients have thinner retinal structures and reduced microvascular densities compared to age-and-sexmatched healthy controls [20,21]; importantly, we further showed alterations of structural changes around the optic nerve head and retina in thalamic stroke patients were related to shrinkage of the optic tract, and all these changes were correlated with visual perfomence [20].…”

“…Some studies previously reported relationships between VA and GCIPL that was related to the pathophysiology of the disease [49]. We previously showed that thalamic stroke patients with a duration > 6-month had thicker retinal structures compared to patients with a duration ≤ 6-month; we also showed that thinning of the GCIPL thickness was associated with deteriorating vision [20]. In current study, as the thickness of the GCIPL reduced, VA in thalamic stroke patients worsened during the early phase (≤ 6-month).…”

“…Multiple linear regression was used to explore the correlation between OCT and OCTA parameters and functional connectivity measures in thalamic stroke patients with age, gender, hypertension, diabetes, dyslipidemia, disease duration, and lesion volume as nuisance variables. Consistent with our previous studies [20,21], strati ed analysis was performed based on a disease duration of 6 months since it has been well recognized that the process of trans-retrograde degeneration is time-dependent[38], along with the time course of poststroke visual de cit becoming steady after 6 months [39]. P-value less than 0.05 (p < 0.05) was considered statistically signi cant.…”

“…Reduced vision is one clinical manifestation after thalamic stroke [20,21,46,47]. Our previous report showed that visual loss in thalamic stroke patients is associated with retinal neurodegeneration [20].…”

Association of retinal thickness and microvasculature with cognitive performance and brain volumes in elderly adults

“…Retinal image acquisition was done in both eyes. Previous reports have detailed the specifications of the SS-OCT/OCTA tool ( Kwapong et al, 2022a , b ; Tao et al, 2022 ; Ye et al, 2022 ). Structural OCT imaging was done with 18 radial B-scans positioned on the fovea.…”