Background

Optical coherence tomography angiography (OCTA) is a novel and noninvasive technique for the quantitative assessment of retinal microvascular perfusion. Since the retinal and cerebral small vessels share similar embryological origins, anatomical features, and physiological properties, altered retinal microvasculature might provide a new perspective on the mechanisms of cerebral small vessel disease (CSVD).

Objective

We aimed to evaluate retinal vessel density (VD) in patients with CSVD using OCTA and identify associations with cerebral magnetic resonance imaging (MRI) markers and cognitive function.

Methods

We prospectively recruited 47 CSVD patients and 30 healthy controls (HCs) to participate in the study. All participants underwent OCTA to evaluate retinal microvascular perfusion. The VDs of the macular region in the superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and foveal avascular zone (FAZ) were determined, along with the VD of the optic nerve head (ONH) in the radial peripapillary capillary (RPC) network. Additionally, cerebral MRI and cognitive function tests were performed.

Results

In the macula area, the VD of the CSVD patients was significantly lower than HCs in the temporal quadrant of SRCP. In the ONH area, CSVD patients had lower VD than HCs in the peripapillary RPC network. According to multiple linear regression analysis, decreased VD of the macular SRCP was associated with white matter hyperintensity scores after adjustment for age, hypertension, diabetes, and hyperlipidemia. Furthermore, the VD of the macular SRCP was significantly correlated with CSVD patients’ cognitive function, especially global cognition, memory function, attention function, information processing, and executive function.

Conclusion

OCTA revealed a significant decrease in retinal microvascular perfusion in CSVD patients, and retinal hypoperfusion was related to MRI markers and cognitive function, suggesting that these parameters could have potential utility as early disease biomarkers.

中文翻译：

---

浅表视网膜毛细血管丛的血管密度作为脑小血管疾病的新生物标志物：光学相干断层扫描血管造影研究

背景

光学相干断层扫描血管造影 (OCTA) 是一种用于定量评估视网膜微血管灌注的新型无创技术。由于视网膜和脑小血管具有相似的胚胎起源、解剖特征和生理特性，改变的视网膜微血管系统可能为脑小血管病 (CSVD) 的机制提供新的视角。

客观的

我们旨在使用 OCTA 评估 CSVD 患者的视网膜血管密度 (VD)，并确定与脑磁共振成像 (MRI) 标志物和认知功能的关联。

方法

我们前瞻性地招募了 47 名 CSVD 患者和 30 名健康对照 (HC) 参与该研究。所有参与者都接受了 OCTA 以评估视网膜微血管灌注。确定了浅表视网膜毛细血管丛 (SRCP)、深部视网膜毛细血管丛 (DRCP) 和中央凹无血管区 (FAZ) 黄斑区的 VD，以及径向视乳头周围视神经乳头 (ONH) 的 VD毛细管 (RPC) 网络。此外，还进行了脑 MRI 和认知功能测试。

结果

在黄斑区，CSVD 患者的 VD 显着低于 SRCP 颞象限的 HC。在 ONH 区域，CSVD 患者的 VD 低于 HCs 在 peripapillary RPC 网络中。根据多元线性回归分析，校正年龄、高血压、糖尿病和高脂血症后，黄斑区 SRCP 的 VD 降低与白质高信号评分相关。此外，黄斑SRCP的VD与CSVD患者的认知功能显着相关，尤其是整体认知、记忆功能、注意力功能、信息处理和执行功能。

结论

OCTA 显示 CSVD 患者视网膜微血管灌注显着减少，视网膜低灌注与 MRI 标志物和认知功能有关，表明这些参数可能具有作为早期疾病生物标志物的潜在用途。