Retinal microvasculature and cerebral small vessel disease in the Lothian Birth Cohort 1936 and Mild Stroke Study

Abstract

Research has suggested that the retinal vasculature may act as a surrogate marker for diseased cerebral vessels. Retinal vascular parameters were measured using Vessel Assessment and Measurement Platform for Images of the Retina (VAMPIRE) software in two cohorts: (i) community-dwelling older subjects of the Lothian Birth Cohort 1936 (n = 603); and (ii) patients with recent minor ischaemic stroke of the Mild Stroke Study (n = 155). Imaging markers of small vessel disease (SVD) (white matter hyperintensities [WMH] on structural MRI, visual scores and volume; perivascular spaces; lacunes and microbleeds), and vascular risk measures were assessed in both cohorts. We assessed associations between retinal and brain measurements using structural equation modelling and regression analysis. In the Lothian Birth Cohort 1936 arteriolar fractal dimension accounted for 4% of the variance in WMH load. In the Mild Stroke Study lower arteriolar fractal dimension was associated with deep WMH scores (odds ratio [OR] 0.53; 95% CI, 0.32–0.87). No other retinal measure was associated with SVD. Reduced fractal dimension, a measure of vascular complexity, is related to SVD imaging features in older people. The results provide some support for the use of the retinal vasculature in the study of brain microvascular disease.

Prediction for the Total MRI Burden of Cerebral Small Vessel Disease With Retinal Microvascular Abnormalities in Ischemic Stroke/TIA Patients

“…Previous studies on the association of the individual cSVD marker and the retinopathy are based on both the Asian cohort (14) and non-Asian cohorts (8,26). Considering that cSVD is more common in Asian population than in other parts of the world (27) and the subjects in this study are all Asian, the association between the total cSVD burden and retinopathy maybe specific in Asian cohorts and should be further investigated in non-Asian cohorts.…”

Systematic Review on Fractal Dimension of the Retinal Vasculature in Neurodegeneration and Stroke: Assessment of a Potential Biomarker

“…Two other studies confirmed a decrease in FD is associated with higher risk of stroke Aliahmad et al, 2014). It has to be noted that both studies analyzed data from subsets of the same Blue Mountains Eye Study (BMES) cohort, with the stroke cases included by Aliahmad et al all being part of those included by Kawasaki et al In acute and subacute setting, studies reported decreased microvascular network complexity in lacunar stroke compared to mild cortical stroke (Doubal et al, 2010), an association between a decrease in arteriolar FD and deep white matter hyperintensity (WMH) scores in patients with a recent lacunar or cortical stroke (McGrory et al, 2019), and a general decrease in FD in ischemic stroke compared to controls without stroke . In contrast, Cheung et al showed an increased FD in patients with acute lacunar stroke compared to patients with other types of acute ischemic stroke (Cheung et al, 2010).…”

“…First of all, study populations were generally well characterized but heterogeneous throughout studies (e.g., ethnicity) and overall of fairly small size. Work by Cheung et al, Ong et al, McGrory et al, and Williams et al comprised larger population samples (Cheung et al, , 2014aOng et al, 2013;Taylor et al, 2015;Williams et al, 2015;McGrory et al, 2019).…”

“…The comparison of many different parameters creates the problem of multiple comparisons and thus increases the likelihood of incorrectly rejecting a null hypothesis. However, only three out of 21 papers reported the use of correction (e.g., Bonferroni correction) to control for this type I error (Taylor et al, 2015;Jung et al, 2019;McGrory et al, 2019).…”

Retinal microvascular features and cognitive change in the Lothian‐Birth Cohort 1936

“…Fourteen measurements were calculated from each retinal image. These measurements were selected from a larger range of VAMPIRE measurements through a data reduction process described in detail previously [24] . To reduce the number of variables, reduce multicollinearity, and increase reliability, the abovementioned measurements from both eyes of each participant were averaged to provide a mean measurement for all variables.…”