Association between retinal vessel density and neuroimaging features and cognitive impairment in cerebral small vessel disease

Ma, Li; Wang, MeiZi; Chen, Huimin; Qu, YuanZhen; Liu, Yang; Wang, Yilong

doi:10.1016/j.clineuro.2022.107407

Cited by 5 publications

(3 citation statements)

References 34 publications

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“…Another interesting observation from our study is that the associations between macular microvascular parameters and CSVD were evident mainly in the left eye. This is in agreement with a hospital-based study of adults (age ≥ 18 years) in Beijing, which showed that lower VD of the left eye, but not right eye, was associated with higher burdens of WMH and EPVS ( 37 ). This may partially be attributed to structural and functional brain asymmetry occurred during normal human brain development ( 32 , 38 ).…”

Section: Discussionsupporting

confidence: 92%

Associations of macular microvascular parameters with cerebral small vessel disease in rural older adults: A population-based OCT angiography study

Dong

Wang

et al. 2023

Front. Neurol.

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ObjectiveTo explore the associations of macular microvascular parameters with cerebral small vessel disease (CSVD) in rural-dwelling older adults in China.MethodsThis population-based cross-sectional study included 195 participants (age ≥ 60 years; 57.4% women) in the optical coherence tomographic angiography (OCTA) sub-study within the Multimodal Interventions to delay Dementia and disability in rural China (MIND-China). Macular microvascular parameters were measured using the OCTA. We automatically estimated volumes of gray matter, white matter, and white matter hyperintensity (WMH), and manually assessed numbers of enlarged perivascular spaces (EPVS) and lacunes on brain magnetic resonance imaging. Data were analyzed with the general linear models.ResultsAdjusting for multiple confounders, lower vessel skeleton density (VSD) and higher vessel diameter index (VDI) were significantly associated with larger WMH volume (P < 0.05). Lower VSD and foveal density-300 (FD-300) of left eye were significantly associated with lower brain parenchymal volume (P < 0.05). In addition, lower areas of foveal avascular zone (FAZ) and FD-300 of left eye were significantly associated with more EPVS (P < 0.05). The associations of abnormal macular microvascular parameters with WMH volume were evident mainly among females. Macular microvascular parameters were not associated with lacunes.ConclusionMacular microvascular signs are associated with WMH, brain parenchymal volume, and EPVS in older adults. The OCTA-assessed macular microvascular parameters can be valuable markers for microvascular lesions in the brain.

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Section: Discussionsupporting

confidence: 92%

Associations of macular microvascular parameters with cerebral small vessel disease in rural older adults: A population-based OCT angiography study

Dong

Wang

et al. 2023

Front. Neurol.

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“…OCTA is a prominent non-invasive and rapid method for detecting blood perfusion in retinal microvessels at different layers and locations. Studies on the relationship between different OCTA indicators and CSVD are limited and have suggested that some retinal vessel densities, such as SRCP and RPC, are related to certain imaging manifestations of CSVD ( Lee et al, 2020 ; Wang et al, 2021 ; Ma et al, 2022 ). Compared to these studies, we analyzed various indicators related to retinal microvascular vessel density more systematically and found that SRCP vessel density is closely related to the severity of CSVD imaging manifestations.…”

Section: Discussionmentioning

confidence: 99%

“…RPC density refers to the density of blood vessels inside the optic disc area containing only capillaries. FD-300 vessel density is defined as foveal vessel density in a 300-μm wide zone around the Foveal Avascular Zone (FAZ) ( Campbell et al, 2017 ; Inanc et al, 2019 ; Ma et al, 2022 ; Tang et al, 2022 ). The ophthalmic results of any one eye of the patient (first data from the left eye, right eye was used if left eye is unavailable) were used for later statistical analysis.…”

Section: Methodsmentioning

confidence: 99%

Retinal structure and vessel density changes in cerebral small vessel disease

Wang,

Wang

et al. 2024

Front. Neurosci.

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BackgroundCerebral small vessel disease (CSVD) attaches people’s attention in recent years. In this study, we aim to explore retinal structure and vessel density changes in CSVD patients.MethodsWe collected information on retinal metrics assessed by optical coherence tomography (OCT) and OCT angiography and CSVD characters. Logistic and liner regression was used to analyze the relationship between retinal metrics and CSVD.ResultsVessel density of superficial retinal capillary plexus (SRCP), foveal density- 300 length (FD-300), radial peripapillary capillary (RPC) and thickness of retina were significantly lower in CSVD patients, the difference only existed in the thickness of retina after adjusted relevant risk factors (OR (95% CI): 0.954 (0.912, 0.997), p = 0.037). SRCP vessel density showed a significant downward trend with the increase of CSVD scores (β: −0.087, 95%CI: −0.166, −0.008, p = 0.031). SRCP and FD-300 were significantly lower in patients with lacunar infarctions and white matter hypertensions separately [OR (95% CI): 0.857 (0.736, 0.998), p = 0.047 and OR (95% CI): 0.636 (0.434, 0.932), p = 0.020, separately].ConclusionSRCP, FD-300 and thickness of retina were associated with the occurrence and severity of total CSVD scores and its different radiological manifestations. Exploring CSVD by observing alterations in retinal metrics has become an optional research direction in future.

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Atherosclerotic burden and cerebral small vessel disease: exploring the link through microvascular aging and cerebral microhemorrhages

Csiszar,

Ungvari,

Patai

et al. 2024

GeroScience

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Cerebral microhemorrhages (CMHs, also known as cerebral microbleeds) are a critical but frequently underestimated aspect of cerebral small vessel disease (CSVD), bearing substantial clinical consequences. Detectable through sensitive neuroimaging techniques, CMHs reveal an extensive pathological landscape. They are prevalent in the aging population, with multiple CMHs often being observed in a given individual. CMHs are closely associated with accelerated cognitive decline and are increasingly recognized as key contributors to the pathogenesis of vascular cognitive impairment and dementia (VCID) and Alzheimer’s disease (AD). This review paper delves into the hypothesis that atherosclerosis, a prevalent age-related large vessel disease, extends its pathological influence into the cerebral microcirculation, thereby contributing to the development and progression of CSVD, with a specific focus on CMHs. We explore the concept of vascular aging as a continuum, bridging macrovascular pathologies like atherosclerosis with microvascular abnormalities characteristic of CSVD. We posit that the same risk factors precipitating accelerated aging in large vessels (i.e., atherogenesis), primarily through oxidative stress and inflammatory pathways, similarly instigate accelerated microvascular aging. Accelerated microvascular aging leads to increased microvascular fragility, which in turn predisposes to the formation of CMHs. The presence of hypertension and amyloid pathology further intensifies this process. We comprehensively overview the current body of evidence supporting this interconnected vascular hypothesis. Our review includes an examination of epidemiological data, which provides insights into the prevalence and impact of CMHs in the context of atherosclerosis and CSVD. Furthermore, we explore the shared mechanisms between large vessel aging, atherogenesis, microvascular aging, and CSVD, particularly focusing on how these intertwined processes contribute to the genesis of CMHs. By highlighting the role of vascular aging in the pathophysiology of CMHs, this review seeks to enhance the understanding of CSVD and its links to systemic vascular disorders. Our aim is to provide insights that could inform future therapeutic approaches and research directions in the realm of neurovascular health.

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Association between retinal vessel density and neuroimaging features and cognitive impairment in cerebral small vessel disease

Cited by 5 publications

References 34 publications

Associations of macular microvascular parameters with cerebral small vessel disease in rural older adults: A population-based OCT angiography study

Associations of macular microvascular parameters with cerebral small vessel disease in rural older adults: A population-based OCT angiography study

Retinal structure and vessel density changes in cerebral small vessel disease

Atherosclerotic burden and cerebral small vessel disease: exploring the link through microvascular aging and cerebral microhemorrhages

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