Hilal Saima, Ong Yi-Ting, Cheung Carol Y, Tan Chuen Seng, Venketasubramanian Narayanaswamy, Niessen Wiro J, Vrooman Henri, Anuar Ainur R, Chew Merwyn, Chen Christopher, Wong Tien Yin, Ikram Mohammad Kamran
Memory, Aging & Cognition Center, National University Health System, Singapore, Singapore; Department of Pharmacology, National University of Singapore, Singapore, Singapore.
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore; NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore.
Neurosci Lett. 2014 Aug 8;577:95-100. doi: 10.1016/j.neulet.2014.06.024. Epub 2014 Jun 14.
Novel retinal imaging techniques have enabled the assessment of quantitative vascular parameters, which provide information on the microvasculature before the appearance of retinopathy signs. Advances in neuroimaging have revealed that cerebral microbleeds (CMB) - besides lacunar infarcts and white matter lesions (WML) - may be a novel marker of cerebral small vessel disease. We examine whether quantitative retinal vascular parameters are related to cerebral small vessel disease in a Chinese population. Participants from Epidemiology of Dementia in Singapore Study underwent comprehensive examinations, including 3-Tesla cranial magnetic resonance imaging and retinal-photography. Retinal vascular parameters (caliber, tortuosity, fractal dimension) were measured from photographs using a semi-automated computer-assisted program. Lacunar infarcts and CMB were visually graded. Total brain and WML volume were obtained using a validated segmentation tool. A total of 261 subjects were included, of whom 36 had lacunar infarcts, 29 had severe WML, and 83 had CMB. In age-sex-adjusted models, narrower retinal arteriolar caliber, wider venular caliber and smaller arteriolar fractal dimension were associated with presence of multiple CMB. In contrast, no association was found with lacunar infarcts and WML volume. After multivariate adjustments, associations of venular caliber, arteriolar fractal dimensions and arteriolar tortuosity with CMB remained statistically significant. In conclusion, subjects with early structural changes in retinal microvasculature were more likely to have CMBs, supporting hypothesis that CMB may be an early manifestation of cerebral small vessel disease.
新型视网膜成像技术已能够评估定量血管参数，这些参数可在视网膜病变体征出现之前提供有关微血管系统的信息。神经影像学的进展表明，除腔隙性梗死和白质病变（WML）外，脑微出血（CMB）可能是脑小血管疾病的一种新型标志物。我们研究了中国人群中视网膜血管定量参数与脑小血管疾病之间是否存在关联。来自新加坡痴呆症流行病学研究的参与者接受了全面检查，包括3特斯拉头颅磁共振成像和视网膜摄影。使用半自动计算机辅助程序从照片中测量视网膜血管参数（管径、迂曲度、分形维数）。腔隙性梗死和CMB通过视觉分级。使用经过验证的分割工具获得全脑和WML体积。总共纳入了261名受试者，其中36人有腔隙性梗死，29人有重度WML，83人有CMB。在年龄和性别调整模型中，较窄的视网膜小动脉管径、较宽的小静脉管径和较小的小动脉分形维数与多个CMB的存在相关。相比之下，未发现与腔隙性梗死和WML体积有关联。经过多变量调整后，小静脉管径、小动脉分形维数和小动脉迂曲度与CMB的关联在统计学上仍然显著。总之，视网膜微血管早期结构改变的受试者更有可能出现CMB，这支持了CMB可能是脑小血管疾病早期表现的假设。
