Static and dynamic retinal vessel analyses in patients with stroke as compared to healthy control subjects

Abstract

PurposeThe retinal microcirculatory bed shares anatomical and physiological characteristics with the cerebral circulation. Static and dynamic changes in the retinal blood vessels can mirror cardio‐ and cerebrovascular events. The aim of the study was to underpin the relevance of retinal analysis for stroke research.Methods18 stroke patients and 16 age‐matched healthy control subjects were included in the present study. Retinal image acquisition was done with a Zeiss fundus camera FF 450plus. Static vessel analysis was done using IFLEXIS software provided by VITO (www.iflexis.com). Retinal vessel dimensions and geometric dimensions were determined. A retinal arteriole and a retinal venule were examined before and after flicker light stimulation for 60 sec. Flicker response, the relative change of vessel diameter due to flicker light stimulation, was calculated using Dynamic Vessel Analysis by imedos (www.imedos.de).ResultsCentral Retinal Arterial Equivalent (CRAE) was significant smaller in stroke patients when compared to the control group, whereas Central Retinal Venular Equivalent (CRVE) was comparable between the groups. Arteriovenous ratio (AVR) was significantly smaller in the stroke group. The analysis further showed significantly smaller daughter arteriolar branches and larger venular branch angles in stroke patients. Dynamic vessel analysis found reduced arteriolar diameters in stroke patients. Response to flicker light was smaller in stroke patients but this difference did not reach level of significance.ConclusionsOur pilot study indicates that retinal analysis is a non‐invasive and convenient tool that is relevant to study microvascular changes in stroke patients The importance of retinal changes as a risk factor for stroke or for patient stratification is now being addressed in follow‐up studies.