Abstract
PurposeTo assess the retinal microvasculature, choriocapillaris, and choroidal thickness in recent single subcortical infarction (RSSI) patients compared with healthy controls. We also assessed the correlation between the macular microvascular changes and choroidal changes with their clinical implications in RSSI patients.MethodsForty-six RSSI patients and 39 healthy controls (HC) were enrolled in our study. Magnetic resonance imaging (MRI) was done for all RSSI patients, and a total cerebral small vessel disease (CSVD) score was assessed for all patients. Swept-source optical coherence tomography (SS-OCT) was used to image and assess the choroidal thickness and SS-OCT angiography (SS-OCTA) was used to image and assess the macular microvasculature and choriocapillaris in all participants. Clinical information was collected for all participants.ResultsRSSI patients showed significantly sparser inner retinal microvasculature (P = 0.003) when compared with healthy controls. RSSI patients showed significantly thinner choroidal thickness (P < 0.001) when compared with HC. No significant difference (P = 0.247) was seen when the choriocapillaris was compared between the two groups. CSVD burden (P = 0.014) and NIHSS score (P = 0.010) showed significant correlation with the inner retinal microvasculature of RSSI patients. The inner retinal microvasculature (P = 0.016) and choroidal thickness (P = 0.018) showed a significant correlation with the MoCA scores in RSSI patients.ConclusionsOur report suggests that retinal and choroidal imaging may serve as useful indicators to expand our understanding of RSSI and its clinical validity.
Highlights
Recent single subcortical infarction (RSSI) formerly known as lacunar stroke accounts for a quarter of all ischemic strokes (Wardlaw, 2005); RSSI is usually caused by cerebral small vessel disease (CSVD) or steno-occlusion of a parent artery in the brain (Bladin and Berkovic, 1984; Jiang et al, 2020, 2021)
The inclusion criteria for recent single subcortical infarction (RSSI) patients were as follows: (1) age 18–80 years old; (2) RSSI in the perforator territory of the middle cerebral artery (MCA) or basilar artery (BA) identified using diffusion-weighted imaging performed within 7 days of symptom onset; (3) no relevant MCA or BA disease confirmed by magnetic resonance angiography (MRA)
Four RSSI patients and 1 Healthy controls (HCs) were excluded from our data analysis because of the presence of age-related macular degeneration (n = 2) and severe glaucoma (n = 3)
Summary
Recent single subcortical infarction (RSSI) formerly known as lacunar stroke accounts for a quarter of all ischemic strokes (Wardlaw, 2005); RSSI is usually caused by cerebral small vessel disease (CSVD) or steno-occlusion of a parent artery in the brain (Bladin and Berkovic, 1984; Jiang et al, 2020, 2021). Eye-related disorders such as reduced vision and motion perception have been reported in patients with lacunar stroke (Rowe et al, 2009; Hepworth et al, 2021). These eye-related disorders have been documented in the early phase of the disease and occur simultaneously with the lesion in the brain (Rowe et al, 2019). To be specific visual abnormalities in lacunar stroke have been suggested to be linked with degeneration of the cerebral visual cortex which may translate to the posterior segment of the eye (Pula and Yuen, 2017)
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