Retinal Structural and Microvascular Alterations in Different Acute Ischemic Stroke Subtypes

Introduction. Retinal structural and microvascular damages reflect damage to cerebral microvasculature and neurons. We aimed to investigate neovascular unit abnormalities among patients with large-artery atherosclerosis (LAA) or small-vessel occlusion (SAA) and control subjects. Methods. Twenty-eigh...

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Main Authors: Ying Zhang, Ce Shi, Yihong Chen, Weicheng Wang, Shenghai Huang, Zhao Han, Xianda Lin, Fan Lu, Meixiao Shen
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2020/8850309
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author Ying Zhang
Ce Shi
Yihong Chen
Weicheng Wang
Shenghai Huang
Zhao Han
Xianda Lin
Fan Lu
Meixiao Shen
author_facet Ying Zhang
Ce Shi
Yihong Chen
Weicheng Wang
Shenghai Huang
Zhao Han
Xianda Lin
Fan Lu
Meixiao Shen
author_sort Ying Zhang
collection DOAJ
description Introduction. Retinal structural and microvascular damages reflect damage to cerebral microvasculature and neurons. We aimed to investigate neovascular unit abnormalities among patients with large-artery atherosclerosis (LAA) or small-vessel occlusion (SAA) and control subjects. Methods. Twenty-eight LAA patients, forty-one SAA patients, and sixty-five age- and gender-matched controls were recruited. Based on optical coherence tomography angiography (OCTA), retinal capillary vessel density was assessed in the general and local sectors, and the thickness of individual retinal layer was extracted from retinal structural images. The differences between structural and microvascular were analyzed. Results. The superior peripapillary retinal nerve fiber layer (pRNFL) thickness was significantly different among the three groups, and the LAA group had the thinnest thickness. Compared to the control group, the deep retinal capillary vessel density in other two stroke subgroups were significantly reduced in all regions except in the inferior region (P < 0.05), and the fractal dimension in C2 and C4 regions of deep retina was significantly lower in the LAA group (P < 0.05). Discussion. Compared with superficial microvascular network, deep microvascular network is more sensitive to ischemic stroke. In addition, we have demonstrated quadrant-specific pRNFL abnormalities in LAA and SAA patients. Superior quadrant pRNFL thickness differences between stroke subgroups may suggest that changes in retinal nerve fiber layer are more sensitive to subtype identification than changes in retinal microvascular structure. All in all, the alteration in retinal structural and microvascular may further elucidate the role of the neovascular unit in ischemic stroke, suggesting that the combination of these two indicators could be used for subtype identification to guide prognosis and establish a risk prediction model.
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spelling doaj-art-c9bc7fb6fc1d49698cfa70df76273f4c2025-08-20T02:19:35ZengWileyJournal of Ophthalmology2090-004X2090-00582020-01-01202010.1155/2020/88503098850309Retinal Structural and Microvascular Alterations in Different Acute Ischemic Stroke SubtypesYing Zhang0Ce Shi1Yihong Chen2Weicheng Wang3Shenghai Huang4Zhao Han5Xianda Lin6Fan Lu7Meixiao Shen8School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, ChinaSchool of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, ChinaSchool of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, ChinaSchool of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, ChinaSchool of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, ChinaThe Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, ChinaThe Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, ChinaSchool of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, ChinaSchool of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, ChinaIntroduction. Retinal structural and microvascular damages reflect damage to cerebral microvasculature and neurons. We aimed to investigate neovascular unit abnormalities among patients with large-artery atherosclerosis (LAA) or small-vessel occlusion (SAA) and control subjects. Methods. Twenty-eight LAA patients, forty-one SAA patients, and sixty-five age- and gender-matched controls were recruited. Based on optical coherence tomography angiography (OCTA), retinal capillary vessel density was assessed in the general and local sectors, and the thickness of individual retinal layer was extracted from retinal structural images. The differences between structural and microvascular were analyzed. Results. The superior peripapillary retinal nerve fiber layer (pRNFL) thickness was significantly different among the three groups, and the LAA group had the thinnest thickness. Compared to the control group, the deep retinal capillary vessel density in other two stroke subgroups were significantly reduced in all regions except in the inferior region (P < 0.05), and the fractal dimension in C2 and C4 regions of deep retina was significantly lower in the LAA group (P < 0.05). Discussion. Compared with superficial microvascular network, deep microvascular network is more sensitive to ischemic stroke. In addition, we have demonstrated quadrant-specific pRNFL abnormalities in LAA and SAA patients. Superior quadrant pRNFL thickness differences between stroke subgroups may suggest that changes in retinal nerve fiber layer are more sensitive to subtype identification than changes in retinal microvascular structure. All in all, the alteration in retinal structural and microvascular may further elucidate the role of the neovascular unit in ischemic stroke, suggesting that the combination of these two indicators could be used for subtype identification to guide prognosis and establish a risk prediction model.http://dx.doi.org/10.1155/2020/8850309
spellingShingle Ying Zhang
Ce Shi
Yihong Chen
Weicheng Wang
Shenghai Huang
Zhao Han
Xianda Lin
Fan Lu
Meixiao Shen
Retinal Structural and Microvascular Alterations in Different Acute Ischemic Stroke Subtypes
Journal of Ophthalmology
title Retinal Structural and Microvascular Alterations in Different Acute Ischemic Stroke Subtypes
title_full Retinal Structural and Microvascular Alterations in Different Acute Ischemic Stroke Subtypes
title_fullStr Retinal Structural and Microvascular Alterations in Different Acute Ischemic Stroke Subtypes
title_full_unstemmed Retinal Structural and Microvascular Alterations in Different Acute Ischemic Stroke Subtypes
title_short Retinal Structural and Microvascular Alterations in Different Acute Ischemic Stroke Subtypes
title_sort retinal structural and microvascular alterations in different acute ischemic stroke subtypes
url http://dx.doi.org/10.1155/2020/8850309
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