Lower Retinal Arteriolar Density Is Associated With Higher Cerebral Small Vessel Disease Burden: An Optical Coherence Tomography Angiography Study

Introduction

It is suggested that cerebral small vessel disease (SVD) plays a role in strokes and dementia. Retinal microvasculature imaged by optical coherence tomography angiography (OCTA) is suggested to be associated with cerebral microvessels. We measured the density of the retinal arterioles and venules on the superficial vascular complex (SVC) of OCTA images and investigated associations with SVD markers in older adults.

Methods

Participants underwent cerebral magnetic resonance imaging and OCTA imaging. An external algorithm (OCTA-Net) was used to segment the retinal vessels into arterioles and venules. SVD indicators [lacunes, white matter hyperintensity (WMH), perivascular spaces (PVS) and cerebral microbleeds (CMBs)] were determined according to the STandards for ReportIng Vascular changes on nEuroimaging (STRIVE)

Results

246 older adults (mean age = 58.84 ± 7.00 years; 38.21 % males) were included in our data analysis. After adjusting for covariates, lower retinal arteriole densities correlated with higher periventricular WMH (p = 0.025) and PVS in the basal ganglia (p = 0.027). Lower retinal venule density correlated with higher deep WMH burden (p = 0.014). Lower arteriolar density was associated with increased SVD burden (p = 0.035). Arteriolar complex branching was associated with periventricular WMH (p = 0.020) while venular complex branching was associated with deep WMH (p = 0.041).

Conclusion

Retinal vascular changes may reflect cerebral vascular changes as evidenced by OCTA-derived metrics.