Retinal vasoreactivity as a marker for chronic ischemic white matter disease?

Bettermann, Kerstin; Slocomb, Julia E.; Shivkumar, Vikram; Lott, Mary E. J.

doi:10.1016/j.jns.2012.05.041

Cited by 17 publications

(17 citation statements)

References 24 publications

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“…(21) The investigators measured retinal vascular reactivity by assessing change in retinal vessel diameter before and during light flicker stimulation. They measured cerebrovascular reactivity with transcranial Doppler measurement of middle cerebral artery blood velocity during breathholding to induce hypercarbia, a known stimulant of vascular muscular relaxation.…”

Section: Relationship Between Chronic Retinal and Cerebral Microvasculamentioning

confidence: 99%

Retinal Vascular Changes are a Marker for Cerebral Vascular Diseases

Moss

2015

Curr Neurol Neurosci Rep

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The retinal circulation is a potential marker of cerebral vascular disease because it shares origin and drainage with the intracranial circulation and because it can be directly visualized using ophthalmoscopy. Cross sectional and cohort studies have demonstrated associations between chronic retinal and cerebral vascular disease, acute retinal and cerebral vascular disease and chronic retinal vascular disease and acute cerebral vascular disease. In particular, certain qualitative features of retinopathy, retinal artery occlusion and increased retinal vein caliber are associated with concurrent and future cerebrovascular events. These associations persist after accounting for confounding variables known to be disease-causing in both circulations, which supports the potential use of retinal vasculature findings to stratify individuals with regards to cerebral vascular disease risk.

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Section: Relationship Between Chronic Retinal and Cerebral Microvasculamentioning

confidence: 99%

Retinal Vascular Changes are a Marker for Cerebral Vascular Diseases

Moss

2015

Curr Neurol Neurosci Rep

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“…Secondly, we wanted to evaluate whether T2DM has additive deleterious effects on WM health in the presence of HTN. Finally, given that retinal vessel integrity can be used as a noninvasive marker of cerebral vascular health [17, 18], we also wanted to ascertain whether there are relationships between retinal arteriolar integrity and the anticipated reductions in DTI-based cerebral WM integrity among hypertensive individuals. …”

Section: Introductionmentioning

confidence: 99%

Cerebral White Matter and Retinal Arterial Health in Hypertension and Type 2 Diabetes Mellitus

Yau

Hempel

Tirsi

et al. 2013

International Journal of Hypertension

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We examined 33 hypertensive (22 with comorbid type 2 diabetes mellitus (T2DM)) and 29 normotensive (8 with T2DM) middle-aged and elderly adults, comparable in age and education. Relative to normotensive participants, those with hypertension, in addition to a higher prevalence of periventricular white matter (WM) lesions, had significantly lower WM microstructural integrity of major fiber tracts as seen with MRI-based diffusion tensor imaging. Among participants with hypertension, those with co-morbid T2DM (n = 22) had more widespread WM pathology than those without T2DM (n = 11). Furthermore and consistent with previous research, both hypertension and T2DM were related to decreased retinal arterial diameter. Further exploratory analysis demonstrated that the observed retinal arteriolar narrowing among individual with hypertension was associated with widespread subclinical losses in WM microstructural integrity and these associations were present predominantly in the frontal lobe. We found that T2DM adds to the damaging effects of hypertension on cerebral WM, and notably these effects were independent of age and body mass index. Given that the decrease in retinal arteriolar diameter may be a biomarker for parallel pathology in cerebral arterioles, our data suggest that the frontal lobe may be particularly vulnerable to microvascular damage in the presence of hypertension and T2DM.

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“…Epidemiological studies have shown that alterations in the architecture of retinal vessels are associated with higher risk of cardiovascular disease and stroke . Wider retinal vein diameters and decreased AVRs correlate with overall higher stroke risk, presence of lacunar infarcts, chronic cerebral ischemic white matter disease, and vascular dementia . These findings suggest that microvascular changes in the eye parallel the development of cerebrovascular disease, although further confirmatory studies are required.…”

Section: Discussionmentioning

confidence: 98%

Impaired Retinal Vasoreactivity: An Early Marker of Stroke Risk in Diabetes

Bettermann

Slocomb

Shivkumar

et al. 2016

Journal of Neuroimaging

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Diabetes is a common cause of small vessel disease leading to stroke and vascular dementia. While the function and structure of large cerebral vessels can be easily studied, the brain's microvasculature remains difficult to assess. Previous studies have demonstrated that structural changes in the retinal vessel architecture predict stroke risk, but these changes occur at late disease stages. Our goal was to examine whether retinal vascular status can predict cerebral small vessel dysfunction during early stages of diabetes. Retinal vasoreactivity and cerebral vascular function were measured in 78 subjects (19 healthy controls, 22 subjects with prediabetes, and 37 with type-2 diabetes) using a new noninvasive retinal imaging device (Dynamic Vessel Analyzer) and transcranial Doppler studies, respectively. Cerebral blood vessel responsiveness worsened with disease progression of diabetes. Similarly, retinal vascular reactivity was significantly attenuated in subjects with prediabetes and diabetes compared to healthy controls. Subjects with prediabetes and diabetes with impaired cerebral vasoreactivity showed mainly attenuation of the retinal venous flicker response. This is the first study to explore the relationship between retinal and cerebral vascular function in diabetes. Impairment of venous retinal responsiveness may be one of the earliest markers of vascular dysfunction in diabetes possibly indicating subsequent risk of stroke and vascular dementia.

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Retinal vasoreactivity as a marker for chronic ischemic white matter disease?

Cited by 17 publications

References 24 publications

Retinal Vascular Changes are a Marker for Cerebral Vascular Diseases

Retinal Vascular Changes are a Marker for Cerebral Vascular Diseases

Cerebral White Matter and Retinal Arterial Health in Hypertension and Type 2 Diabetes Mellitus

Impaired Retinal Vasoreactivity: An Early Marker of Stroke Risk in Diabetes

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