Debourdeau Eloi, Chamard Chloe, Ayrignac Xavier, Varnier Quentin, Crowdy Hannah, Villain Max, Arquizan Caroline, Daien Vincent, Ter Schiphorst Adrien
Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France.
Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, Montpellier, France.
Retina. 2025 May 1;45(5):915-927. doi: 10.1097/IAE.0000000000004378.
To investigate retinal microvascular changes in ischemic stroke patients using optical coherence tomography angiography (OCT-A) and assess these alterations based on stroke etiology.
Case-control study conducted at Montpellier University Hospital from May 2021 to March 2022 (Institutional Review Board: 202000607). Retinal vascular features were compared between strokes patients and age-matched and sex-matched controls. Optical coherence tomography angiography was performed using RTVue-XR-Avanti with AngioVue (Optovue). Multivariate mixed-effects analysis of covariance models adjusted for age, sex, intraocular pressure, and cardiovascular risk factors were used.
Ninety-two eyes were included: 21 with micro-/macroangiopathy stroke, 12 with etiologically ambiguous stroke, 13 with cardioembolic stroke, and 46 eyes from control subjects. After adjusting for age, sex, and intraocular pressure, stroke patients had significantly lower parafoveal superficial capillary plexus vessel density ( P = 0.013) and superficial capillary plexus flow index ( P = 0.023) compared with control subjects, especially in the macro-/microangiopathy subgroup. When cardiovascular risk factors were included, only the superficial capillary plexus flow index difference remained significant ( P = 0.023). Optical coherence tomography angiography's diagnostic accuracy was validated with an area under the receiver operating characteristic curve of 0.83.
Optical coherence tomography angiography effectively detects retinal microvascular alterations in stroke patients, with persistent alterations in macro-/microangiopathy strokes after adjusting for cardiovascular risk factors. These findings support OCT-A's role in stroke subtype classification.
使用光学相干断层扫描血管造影（OCT-A）研究缺血性中风患者的视网膜微血管变化，并根据中风病因评估这些改变。
于2021年5月至2022年3月在蒙彼利埃大学医院进行病例对照研究（机构审查委员会：202000607）。比较中风患者与年龄和性别匹配的对照组的视网膜血管特征。使用配备AngioVue的RTVue-XR-Avanti（Optovue）进行光学相干断层扫描血管造影。采用多变量混合效应协方差分析模型，并对年龄、性别、眼压和心血管危险因素进行了校正。
纳入92只眼：21只患有微血管/大血管病变性中风，12只病因不明的中风，13只心源性栓塞性中风，46只来自对照受试者的眼睛。在对年龄、性别和眼压进行校正后，中风患者的黄斑旁浅表毛细血管丛血管密度（P = 0.013）和浅表毛细血管丛血流指数（P = 0.023）明显低于对照受试者，尤其是在微血管/大血管病变亚组中。当纳入心血管危险因素时，只有浅表毛细血管丛血流指数差异仍然显著（P = 0.023）。光学相干断层扫描血管造影的诊断准确性通过受试者操作特征曲线下面积为0.83得到验证。
光学相干断层扫描血管造影可有效检测中风患者的视网膜微血管改变，在对心血管危险因素进行校正后，微血管/大血管病变性中风中仍存在持续性改变。这些发现支持OCT-A在中风亚型分类中的作用。
