Retinal layers and visual conductivity changes in a case series of microangiopathic ischemic stroke patients

Abstract

Background: It is unknown whether microangiopathic ischemic strokes outside the visual pathway go along with subclinical changes of the retinal structure or the visual system. The objectives of this prospective noninterventional case series were to investigate if spectral-domain optical coherence tomography (SD-OCT) or multifocal visual evoked potentials (mfVEPs) can detect structural retinal changes or functional impairment of the visual system in patients with microangiopathic ischemic stroke. Methods: We used SD-OCT to cross-sectionally analyze the retinal morphology of 15 patients with microangiopathic ischemic stroke according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification not affecting the visual pathway. We employed semi-automated segmentation of macular volume scans to analyze the thickness of the macular retinal layers and peripapillary ring scans to investigate the retinal morphology in comparison to a control group without stroke. Visual function was assessed by the mfVEP technique in 13 microangiopathic ischemic stroke patients. Results: First peak latency of mfVEPs was significantly delayed in the microangiopathic ischemic stroke group compared to the control patients. Neither the retinal layers nor the mfVEPs' amplitude differed between the microangiopathic ischemic stroke patients and the control group. Conclusions: In conclusion, microangiopathic ischemic stroke patients presented a delayed first peak latency in mfVEPs as a sign of subclinical functional impairment of the visual pathway. However, our case series suggests no influence on retinal structure resulting from microangiopathic ischemic stroke outside the visual system. Larger and longitudinal studies are needed to confirm these mfVEP findings.

Changes of the retinal and choroidal vasculature in cerebral small vessel disease

“…Our study supports this assumption and complements it with the more detailed view of the retinal capillaries and the choriocapillaris visualized by OCT-A. Lee et al 27 investigated structural retinal changes in 15 individuals with ischemic stroke using OCT but did not identify any significant structural alterations that may result from the capillary flow impairment identified in our study. Overall, the reported anatomic locations of retinal vessel flow pathologies in CSVD remain inconsistent but we have newly identified alterations in the superficial proportion of the choroidal layer in these patients.…”