Retinal Microvasculature Reveals Clues About Stroke Subtypes

Published on December 23, 2022

Imagine retinal blood vessels as tiny spies, secretly holding clues about the different types of strokes. A recent study used optical coherence tomography angiography (OCTA) to investigate the retinal microvasculature differences between patients with large artery atherosclerosis (LAA) and small artery disease (SAD). By examining the vessel area density (VAD) in the superficial and deep vascular complexes of the retina, researchers discovered that LAA patients had significantly reduced density in the deep complex compared to SAD patients. Additionally, anterior LAA patients exhibited lower density in the superficial complex compared to posterior LAA patients. These findings highlight the potential of retinal imaging in identifying microvasculature changes associated with specific stroke subtypes. With further research, this non-invasive technique may contribute to early detection and targeted treatment of ischemic strokes. Explore the fascinating details of this study in the linked article!

Purpose: Recent reports suggest retinal microvasculature mirror cerebral microcirculation. Using optical coherence tomography angiography (OCTA), we investigated the retinal microvasculature differences between ischemic stroke patients with large artery atherosclerosis (LAA) and small artery disease (SAD).Methods: All patients underwent MR imaging and were classified as SAD and LAA; LAA was subdivided into anterior LAS and posterior LAS depending on the location. Swept-source OCTA (SS-OCTA) was used to image and segment the retina into the superficial vascular complex (SVC) and deep vascular complex (DVC) in a 6 × 6 mm area around the fovea. A deep learning algorithm was used to assess the vessel area density (VAD, %) in the retinal microvasculature.Results: Fifty-eight (mean age = 60.26 ± 10.88 years; 81.03% males) were LAA while 64 (mean age = 55.58 ± 10.34 years; 85.94% males) were SAD. LAS patients had significantly reduced VAD in the DVC (P = 0.022) compared to SAD patients; the VAD in the SVC did not show any significant difference between the two groups (P = 0.580). Anterior LAA ischemic stroke showed significantly lower VAD (P = 0.002) in the SVC compared with posterior LAS patients. There was no significant difference in the DVC between the two groups (P = 0.376).Conclusions: We found LAA patients had significantly reduced DVC density compared with SAD; we also showed anterior LAA patients had significantly reduced SVC density compared with posterior LAA. These findings suggest retinal imaging has the potential to be used to detect microvasculature changes in subtypes of ischemic stroke.

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