Abnormalities of retinal structure and microvasculature are associated with cerebral white matter hyperintensities

Zhou, Xirui; Li, Tao; Qu, Wensheng; Pan, Dengji; Qiu, Qianwen; Wu, Lingshan; Zhao, Jing; Yu, Zhiyuan; Huang, Hao; Luo, Xiang

doi:10.1111/ene.15378

Cited by 9 publications

(6 citation statements)

References 64 publications

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“…Similar observations have documented that the thinning of RNFL was related to the degree of WMH ( 30 , 33 , 34 , 62 ). However, a prospective study unexpectedly showed that WMH aggravation was not related to the decrease in RNFL thickness ( 63 ).…”

Section: Discussionsupporting

confidence: 87%

“…OCTA is a novel technique used to image retinal microvascular impairment rapidly and non-invasively. Increasing evidence shows that microvascular density evaluated by OCTA is associated with the degree of WMH, notably the DWMH, which is related to the thinning of RNFL ( 29 , 34 ). It suggests that microvascular damage occurs in both the retina and brain, results in impaired neurovascular coupling, and eventually leads to nerve fiber lesions ( 30 , 31 , 45 ).…”

Section: Discussionmentioning

confidence: 99%

“…Qu et al found that retinal degeneration in the RNFL and GCIP was independently associated with WMH, and deteriorated with the severity of the WMH ( 33 ). A recent study also showed that abnormalities in retinal microvascular density, morphological parameters, and RNFL thickness were correlated with the incidence of moderate-severe WMH ( 34 ). Carolina et al evaluated the WM integrity tract by diffusion tensor imaging and found that GCL and IPL thickness could reflect the whole-brain WM dysfunction in patients with multiple sclerosis ( 35 ).…”

Section: Introductionmentioning

confidence: 97%

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Retinal thickness changes in different subfields reflect the volume change of cerebral white matter hyperintensity

Teng²,

Jia³

et al. 2022

Front. Neurol.

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PurposeTo investigate the relationship between the retinal thickness in different subfields and the volume of white matter hyperintensity (WMH), with the hope to provide new evidence for the potential association between the retina and the brain.MethodsA total of 185 participants aged over 40 years were included in our study. Magnetic resonance imaging (MRI) was used to image the WMH, and WMH volume was quantitatively measured by a specific toolbox. The thickness of the total retina, the retinal nerve fiber layer (RNFL), and the ganglion cell and inner plexiform layer (GCIP) was measured by optical coherence tomography (OCT) in nine subfields. The association between retinal thickness and WMH volume was demonstrated using binary logistic regression and Pearson correlation analysis.ResultsParticipants were divided into two groups by the WMH volume (‰, standardized WMH volume) median. In the quartile-stratified binary logistic regression analysis, we found that the risk of higher WMH volume showed a positive linear trend correlation with the thickness of total retina (95% CI: 0.848 to 7.034; P for trend = 0.044)/ GCIP (95% CI: 1.263 to 10.549; P for trend = 0.038) at the central fovea, and a negative linear trend correlation with the thickness of nasal inner RNFL (95% CI: 0.086 to 0.787; P for trend = 0.012), nasal outer RNFL (95% CI: 0.058 to 0.561; P for trend = 0.004), and inferior outer RNFL (95% CI: 0.081 to 0.667; P for trend = 0.004), after adjusting for possible confounders. Correlation analysis results showed that WMH volume had a significant negative correlation with superior outer RNFL thickness (r = −0.171, P = 0.02) and nasal outer RNFL thickness (r = −0.208, P = 0.004).ConclusionIt is suggested that central fovea and outer retina thickness are respectively associated with WMH volume. OCT may be a biological marker for early detection and longitudinal monitoring of WMH.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Retinal thickness changes in different subfields reflect the volume change of cerebral white matter hyperintensity

Teng²,

Jia³

et al. 2022

Front. Neurol.

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“…PWMH is more likely to be determined by chronic hemodynamic insufficiency, whereas DWMH may be more attributed to small vessel disease ( 32 ). In line with this view, two hospital-based case-control studies suggested that lower vessel density was associated with severity of DWMH but not PWMH ( 26 , 31 ). However, our study indicated that lower VSD and higher VDI were associated with higher PWMH volume, but not with DWMH volume.…”

Section: Discussionmentioning

confidence: 79%

“…Previously, a population-based cohort study has linked the larger venular diameters with the progression of WMH (5). By contrast, the small-scale case-control study (n = 64) in Wuhan, China found no association between VDI and WMH (e.g., PWMH and DWMH), partly due to limited statistical power (31). Taken together, the findings from our population-based study and previous case-control studies suggest that macular microvascular parameters can be valuable markers for microvascular lesions in the brain.…”

Section: Discussionmentioning

confidence: 95%

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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Retina as a potential biomarker for the early stage of Alzheimer's disease spectrum

Gao,

Luo,

Yan

et al. 2024

Ann Clin Transl Neurol

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ObjectiveTo characterize the retinal microvasculature and structure in subjective cognitive decline (SCD) and identify the potential biomarker for the early stage of the Alzheimer's disease (AD) spectrum.MethodsIn this study, 35 patients with SCD, 36 with cognitive impairment, and 29 with normal cognition (NC) were enrolled. Optical coherence tomography angiography was employed to assess retinal vascular density, fovea avascular zone area, and retinal thickness. The parameters reflecting retinal perfusion and structure were compared among the three groups. In addition, the association between retinal parameters, cerebral blood flow (CBF), and peripheral blood biomarkers in the SCD stage was analyzed.ResultsThe superficial vascular complex (SVC) vascular density in the macula and retinal nerve fiber layer thickness in the peripapillary were significantly reduced in individuals with SCD compared to NC. Furthermore, there was a positive correlation between macular ganglion cell complex thickness and CBF in SCD.InterpretationThe retinal microvasculature and structure exhibit alterations in individuals with SCD. Macular ganglion cell complex thickness demonstrates correlations with cerebral perfusion. The retina holds potential as a novel biomarker for early detection of AD.

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Abnormalities of retinal structure and microvasculature are associated with cerebral white matter hyperintensities

Cited by 9 publications

References 64 publications

Retinal thickness changes in different subfields reflect the volume change of cerebral white matter hyperintensity

Retinal thickness changes in different subfields reflect the volume change of cerebral white matter hyperintensity

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

Retina as a potential biomarker for the early stage of Alzheimer's disease spectrum

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