Structural retinal changes in cerebral small vessel disease

Abstract

Cerebral small vessel disease (CSVD) is an important contributor to cognitive impairment and stroke. Previous research has suggested associations with alterations in single retinal layers. We have assessed changes of all individual retinal layers in CSVD using high-resolution optical coherence tomography (OCT) for the first time. Subjects with recent magnetic resonance imaging (MRI) underwent macular and peripapillary retinal imaging using OCT for this case–control study. Number and volume ratio index (WMRI) of white matter lesions (WML) were determined on MRI. Data were analyzed using multiple linear regression models. 27 CSVD patients and 9 control participants were included. Ganglion cell layer (GCL) volume was significantly reduced in patients with CSVD compared to age-matched controls (p = 0.008). In patients with CSVD, larger foveal outer plexiform layer (OPL) volume and decreased temporal peripapillary retinal nerve fiber layer (RNFL) thickness were significantly associated with a higher WMRI in linear regression when controlling for age (p ≤ 0.033). Decreased foveal GCL volume and temporal-inferior RNFL thickness at Bruch’s membrane opening (MRW), and increased temporal MRW were associated with a higher WML burden (p ≤ 0.037). Thus, we identified alterations in several OCT layers in individuals with CSVD (GCL, OPL, MRW and RNFL). Their potential diagnostic value merits further study.

Retinal structure and vessel density changes in cerebral small vessel disease

“…In previous studies, we found that changes in RNFL thickness were closely related to stroke events, and some studies have also suggested the relationship between RNFL and GCC thickness changes and different imaging changes in CSVD ( Wang et al, 2014 ; Simsek, 2017 ; Langner et al, 2022 ). Since SRCP is mainly distributed in the RNFL and GCC layers, there should theoretically be consistency between the two changes.…”

The association of global vessel width with cognitive decline and cerebral small vessel disease burden in the KaiLuan study

“…There is mounting evidence that retinal biomarkers are related to the emergence of various CSVD imaging features, which is important for the increased risk of cognitive impairment ( 20 , 34 ). It has been reported that the CSVD burden was associated with a wider CRVE, a smaller AVR, and a higher incidence of vessel tortuosity ( 35 ).…”

Analysis of risk and protective factors associated with retinal nerve fiber layer defect in a Chinese adult population

“…RNFLD can be found in eyes with ischemic optic neuropathy, glaucomatous optic neuropathy, optic disc drusen, retinitis pigmentosa, retinal artery occlusion, contusion of the optic nerve, compression of pituitary tumor, visual pathway impairment, toxic optic neuropathy, and as a sequela of long-standing papilledema, optic neuritis, etc [1][2][3][4][5][6][7][8] . In addition, many risk factors, such as age, race, gender, blood pressure, blood glucose, smoke, etc., are known to increase an individual's chance of developing RNFLD [9][10][11] . RNFLD may result in vision loss.…”

“…Most of the studies used color fundus photographs to diagnose RNFLD. Previous research suggested that RNFLD play a significant role in the detection of various abnormal physical condition and diseases, such as diabetic mellitus, stroke, hypertension, Alzheimer's disease, multiple sclerosis, Parkinson's disease, pathologic myopia, etc [9,[12][13][14][15][16] . Some studies indicated that the prevalence of RNFLD in health examination participants is about 4.7%-5.4% [16][17] .…”