Retinal vasoreactivity as a marker for chronic ischemic white matter disease?

Kerstin Bettermann, Julia E. Slocomb, Vikram Shivkumar, Mary E J Lott

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The cerebral microvasculature cannot be easily studied non-invasively. Because the retina and brain share embryological, anatomical and physiological similarities, studies of retinal blood vessels may prove to be useful as a surrogate marker for cerebrovascular disease. In epidemiological studies abnormal retinal arteriovenous ratios (AVRs) predict the risk of stroke and vascular dementia. However, the association between retinal vasoreactivity, cerebral small vessel ischemic disease, and cerebral blood vessel function remains unknown. Study Goals: To examine (1) the association between cerebral ischemic white matter disease (WMD) and retinal microvessel behavior and (2) the relationship between retinal blood vessel reactivity and measures of cerebrovascular function. Methods: Cohort study of 12 patients with ischemic WMD and 14 healthy controls. Retinal vasoreactivity was measured following high frequency flicker light stimulation. Middle cerebral artery (MCA) vasoreactivity was measured using transcranial Doppler ultrasound (TCD). Magnetic resonance imaging scans (MRIs) were reviewed for evidence of ischemic WMD. Results: Patients with ischemic WMD had attenuated retinal venous (2.2% ± 0.27 SD, vs. controls 6% ± 0.7 SD, p = 0.002, CI 95%) and arterial (1.9% ± 0.8 SD, vs. controls 4.9% ± 0.8 SD, p = 0.004, CI 95%) vasoreactivity compared to controls. An attenuated retinal venous light flicker response was associated with a significant decrease of MCA vasoreactivity (r = 0.45, p = 0.05, CI 95%). Decreased AVRs, an indicator for altered retinal vessel architecture in patients with cerebral chronic ischemic WMD, were also significantly correlated with dysfunction of cerebral vasoreactivity (r = 0.69, p = 0.001, CI 95%). Conclusion: In this study functional and structural impairment of the retinal microvasculature were associated with ischemic WMD and measures of cerebral vascular function. Microvascular dysfunction in the eye may predict cerebral small vessel disease, but validation by larger studies is needed.

Original languageEnglish (US)
Pages (from-to)206-210
Number of pages5
JournalJournal of the neurological sciences
Volume322
Issue number1-2
DOIs
StatePublished - Nov 15 2012

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Leukoencephalopathies
Retinal Vessels
Cerebral Small Vessel Diseases
Microvessels
Middle Cerebral Artery
Blood Vessels
Magnetic Resonance Imaging
Cerebrovascular Disorders
Light
Doppler Ultrasonography
Vascular Dementia
Validation Studies
Retina
Epidemiologic Studies
Cohort Studies
Biomarkers
Stroke
Odds Ratio
Brain

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Neurology

Cite this

Bettermann, Kerstin ; Slocomb, Julia E. ; Shivkumar, Vikram ; Lott, Mary E J. / Retinal vasoreactivity as a marker for chronic ischemic white matter disease?. In: Journal of the neurological sciences. 2012 ; Vol. 322, No. 1-2. pp. 206-210.
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title = "Retinal vasoreactivity as a marker for chronic ischemic white matter disease?",
abstract = "The cerebral microvasculature cannot be easily studied non-invasively. Because the retina and brain share embryological, anatomical and physiological similarities, studies of retinal blood vessels may prove to be useful as a surrogate marker for cerebrovascular disease. In epidemiological studies abnormal retinal arteriovenous ratios (AVRs) predict the risk of stroke and vascular dementia. However, the association between retinal vasoreactivity, cerebral small vessel ischemic disease, and cerebral blood vessel function remains unknown. Study Goals: To examine (1) the association between cerebral ischemic white matter disease (WMD) and retinal microvessel behavior and (2) the relationship between retinal blood vessel reactivity and measures of cerebrovascular function. Methods: Cohort study of 12 patients with ischemic WMD and 14 healthy controls. Retinal vasoreactivity was measured following high frequency flicker light stimulation. Middle cerebral artery (MCA) vasoreactivity was measured using transcranial Doppler ultrasound (TCD). Magnetic resonance imaging scans (MRIs) were reviewed for evidence of ischemic WMD. Results: Patients with ischemic WMD had attenuated retinal venous (2.2{\%} ± 0.27 SD, vs. controls 6{\%} ± 0.7 SD, p = 0.002, CI 95{\%}) and arterial (1.9{\%} ± 0.8 SD, vs. controls 4.9{\%} ± 0.8 SD, p = 0.004, CI 95{\%}) vasoreactivity compared to controls. An attenuated retinal venous light flicker response was associated with a significant decrease of MCA vasoreactivity (r = 0.45, p = 0.05, CI 95{\%}). Decreased AVRs, an indicator for altered retinal vessel architecture in patients with cerebral chronic ischemic WMD, were also significantly correlated with dysfunction of cerebral vasoreactivity (r = 0.69, p = 0.001, CI 95{\%}). Conclusion: In this study functional and structural impairment of the retinal microvasculature were associated with ischemic WMD and measures of cerebral vascular function. Microvascular dysfunction in the eye may predict cerebral small vessel disease, but validation by larger studies is needed.",
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Retinal vasoreactivity as a marker for chronic ischemic white matter disease? / Bettermann, Kerstin; Slocomb, Julia E.; Shivkumar, Vikram; Lott, Mary E J.

In: Journal of the neurological sciences, Vol. 322, No. 1-2, 15.11.2012, p. 206-210.

Research output: Contribution to journalArticle

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N2 - The cerebral microvasculature cannot be easily studied non-invasively. Because the retina and brain share embryological, anatomical and physiological similarities, studies of retinal blood vessels may prove to be useful as a surrogate marker for cerebrovascular disease. In epidemiological studies abnormal retinal arteriovenous ratios (AVRs) predict the risk of stroke and vascular dementia. However, the association between retinal vasoreactivity, cerebral small vessel ischemic disease, and cerebral blood vessel function remains unknown. Study Goals: To examine (1) the association between cerebral ischemic white matter disease (WMD) and retinal microvessel behavior and (2) the relationship between retinal blood vessel reactivity and measures of cerebrovascular function. Methods: Cohort study of 12 patients with ischemic WMD and 14 healthy controls. Retinal vasoreactivity was measured following high frequency flicker light stimulation. Middle cerebral artery (MCA) vasoreactivity was measured using transcranial Doppler ultrasound (TCD). Magnetic resonance imaging scans (MRIs) were reviewed for evidence of ischemic WMD. Results: Patients with ischemic WMD had attenuated retinal venous (2.2% ± 0.27 SD, vs. controls 6% ± 0.7 SD, p = 0.002, CI 95%) and arterial (1.9% ± 0.8 SD, vs. controls 4.9% ± 0.8 SD, p = 0.004, CI 95%) vasoreactivity compared to controls. An attenuated retinal venous light flicker response was associated with a significant decrease of MCA vasoreactivity (r = 0.45, p = 0.05, CI 95%). Decreased AVRs, an indicator for altered retinal vessel architecture in patients with cerebral chronic ischemic WMD, were also significantly correlated with dysfunction of cerebral vasoreactivity (r = 0.69, p = 0.001, CI 95%). Conclusion: In this study functional and structural impairment of the retinal microvasculature were associated with ischemic WMD and measures of cerebral vascular function. Microvascular dysfunction in the eye may predict cerebral small vessel disease, but validation by larger studies is needed.

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