视网膜浅层毛细血管丛血管密度作为脑小血管病的一种新生物标志物：一项光相干断层扫描血管造影研究。

The vessel density of the superficial retinal capillary plexus as a new biomarker in cerebral small vessel disease: an optical coherence tomography angiography study.

机构信息

Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.

Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China.

出版信息

Neurol Sci. 2021 Sep;42(9):3615-3624. doi: 10.1007/s10072-021-05038-z. Epub 2021 Jan 11.

DOI:10.1007/s10072-021-05038-z

PMID:33432462

Abstract

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.

摘要

背景

光学相干断层扫描血管造影术（OCTA）是一种用于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，因此视网膜微血管的改变可能为脑小血管疾病（CSVD）的发病机制提供新的视角。

目的

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

方法

我们前瞻性招募了 47 例 CSVD 患者和 30 名健康对照者（HCs）参与研究。所有参与者均接受 OCTA 检查以评估视网膜微血管灌注。测量黄斑区浅层视网膜毛细血管丛（SRCP）、深层视网膜毛细血管丛（DRCP）和黄斑无血管区（FAZ）的 VD，以及视盘周围毛细血管（RPC）网络中视神经头（ONH）的 VD。此外，还进行了脑 MRI 和认知功能测试。

结果

在黄斑区，CSVD 患者颞侧 SRCP 的 VD 明显低于 HCs。在 ONH 区，CSVD 患者的视盘周围 RPC 网络的 VD 低于 HCs。经年龄、高血压、糖尿病和高脂血症校正后，黄斑 SRCP 的 VD 降低与脑白质高信号评分相关。此外，黄斑 SRCP 的 VD 与 CSVD 患者的认知功能显著相关，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。