Retinal vascular changes in persons with cerebral small vessel disease

Abstract

The retinal and cerebral microvasculature share many morphological and physiological properties, Hence, it is thought that studying these retinal vessels will provide a direct measure to evaluate the vascular and neuronal status of the brain. In the present study, we aimed to study retinal vasculature by fundus examination in persons identified to have cerebral small vessel disease on MRI brain and an attempt to correlate the retinal vascular changes with the degree of MRI brain changes. A case control study was conducted in the department of Neurology, Jubilee Mission Medical College & Research Institute. A total of 180 patients, included 90 patients for case group (Cerebral small vessel disease on MRI brain) and 90 patients for control group (no cerebral small vessel disease on MRI brain) reporting to the neurology department were included in the study. Cerebral small vessel disease was identified and classified/graded as per the modified Fazeka Scale. Ophthalmoscopic examination was done using fundus camera with the help of the ophthalmologist. Results were expressed in percentages and the data obtained was analysed using standard analytical techniques using SPSS software. Majority of cases and controls were in the age group of 61-70 years. Majority of the cases were males 55 (61.1%). Majority of the controls were females 51 (56.7%). 42 (46.7%) cases and 34 (37.8%) controls were hypertensives. Cases with CSVD had a statistically significant association with arteriolar narrowing, AV crossing changes and optic disc edema when compared to controls. Retinal vascular changes were associated with increased cerebral vascular events. These associations persist after accounting for confounding variables known to be disease causing in both circulations.