The Role of Retinal Vascular Density as a Screening Tool for Ageing and Stroke

Abstract

Objectives: To measure the density of retinal vessels from digitized fundus photographs in patients with recent stroke and age-matched controls. To investigate whether the parameter retinal vascular density (RVD) served as a quantitative marker for cerebrovascular events. Methods: Digitized fundus photographs of n = 158 subjects with stroke or transient ischemic attack within 1 year at the time of examination and n = 1,250 age-matched controls without any remarkable medical history were examined. Sex, hypertension, and diabetes were considered to be cofactors. Measurement of RVD was performed with a computer-aided image-analyzing program by segmenting automatically all visible retinal vessels and measuring areas of vessels in distinct circles around the optic disk. Results: In controls RVD dwindles with increasing distance from the optic disk. RVD decreased significantly with age (p = 0.000). Stroke patients showed significantly lower values of RVD of –15% in comparison to age-matched controls. In old subjects, stroke in combination with hypertension is associated with a significant decreased RVD, and in middle-aged subjects diabetes and stroke are associated with a significant decreased RVD (p = 0.01). Conclusion: Age and stroke are significant risk factors for decreased RVD. Diabetes and arterial hypertension are additional significant risk factors in patients with stroke with respect to RVD.

Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography Study

“…Subjects recruited were local Chinese patients between the ages of 40 and 70 years who had been diagnosed with essential hypertension. Excluded from the study were participants with moderate or severe refractive error (higher than +3.0 diopter or lower than -3.0 diopter), history of glaucoma, history of ophthalmic surgery or retinal diseases, secondary causes of hypertension, BP higher than 160/100 after treatment, HbA1c higher than 6.1%, cardiac functional classification higher than grade 1, hypertensive complications other than retinopathy, coronary heart disease, 23 stroke history, 24 neurodegenerative diseases, 25 migraine, 26 or sleep apnea. 27 Patients with arrythmia or mental disorders or who were undergoing hormone therapies were also excluded for health and safety reasons.…”

Automated diagnosis and quantitative analysis of plus disease in retinopathy of prematurity based on deep convolutional neural networks

“…Blood vessel density was evaluated as the ratio of vessel area to the area of the ROI without the OD (Sprödhuber et al. ).…”

Macula Structure and Microvascular Changes in Recent Small Subcortical Infarct Patients

“…Additionally, we showed that RSSI patients have significantly reduced pRNFL thickness and have a larger FAZ area than the healthy controls. Previous reports used fundus photography to evaluate the retinal vasculature in ischemic stroke (9,14). Nonetheless, using these imaging modalities limits the resolution and depth of imaging; moreover, these imaging modalities cannot visualize the deeper retinal layers in the retina and cannot give additional information on the capillary structure in the retina.…”

“…Previous reports (7,9,21) used different algorithms to evaluate the photography in patients with ischemic stroke; these reports showed that patients with ischemic stroke have significant arteriolar and venular changes than healthy controls. Sprodhuber et al (9) also showed that patients with ischemic stroke have significantly reduced retinal vascular density than healthy controls. The SRCP is within the retinal nerve fiber layer (RNFL) and superficial portion of the ganglion cell complex (GCC), which consists of both large vessels and microvessels (22) as seen via the fundus photography.…”

“…Patients who have suffered from stroke have been reported to show a higher prevalence of retinal microangiopathic conditions when matched with healthy controls (6); ophthalmological findings such as retinal microaneurysms have been reported to be some of the clinical manifestations associated with ischemic stroke. Reports from the past decade used retinal imaging to study cerebral diseases such as pre-asymptomatic stroke (7)(8)(9). These reports showed that the retinal vasculature caliber, tortuosity, and fractal dimension reflect the cerebral vasculature during the disease cascade of ischemic stroke.…”