Imaging Techniques Research Articles

VLT/MUSE Detection of Accretion/Ejection Associated with the Close Stellar Companion in the HT Lup System

The accretion/ejection processes in T Tauri stars are fundamental to their physical evolution, while also impacting the properties and evolution of the circumstellar material at a time when planet formation takes place. To date, the characterization of ongoing accretion processes in stellar pairs at 5–50 au scales has been challenging as high-angular resolution spectrographs are required to extract the spectral features of each component. We present the analysis of spectroscopic observations of the tight (160 mas, 25 au) T Tauri system HT Lup A/B, obtained with MUSE at the Very Large Telescope in 2021 March and July. We focus on constraining the accretion/ejection processes and variability of the secondary component HT Lup B by searching for accretion tracers by applying high-resolution spectral differential imaging techniques. We retrieve strong (signal-to-noise ratio > 5) Hα, Hβ, and [O i]λ6300 emission in both epochs. The Hα and Hβ line fluxes showcase high variability, with variations up to 200%–300% between epochs. The fluxes are consistent with accretion rates of 3× 10−9 M ⊙ yr−1 and 8 × 10−10 M ⊙ yr−1 for the first and second epochs, respectively. We attribute the increased accretion activity during the first night to a “burst-like” event, followed by a relaxation period more representative of the common accretion activity of the system. The [O i]λ6300 line profiles remain relatively similar between epochs and suggest ejection rates on the order of 10−9−10−10 M ⊙ yr−1, compatible with moderate disk wind emission. Our results also indicate that the accretion processes of HT Lup B are compatible with Classical T Tauri stars, unlike previous classifications.

Imaging Pearls and Findings After Prior Shoulder Stabilization

This chapter emphasizes the significance of advanced imaging techniques, particularly MRI, in diagnosing the underlying causes of failed stabilization, such as recurrent labral tears, capsular deficiency, and glenoid bone loss. Key criteria for evaluating labral integrity post-surgery are discussed, alongside the importance of assessing the capsule and inferior glenohumeral ligament for signs of laxity or tears. Advanced MRI methodologies enable precise assessment of bony structures, while the interplay of imaging findings with history informs clinical decisions regarding revision surgery. Ultimately, integrating advanced imaging examination and surgical expertise can enhance patient outcomes and contribute to long-term shoulder functionality.

Neutron tomography and image registration methods to study local physical deformations and attenuation variations in treated archaeological iron nail samples

This study presents a preliminary examination of the effects of environment changes post-excavation on heavily corroded archaeological Roman iron nails using neutron tomography and image registration techniques. Roman nails were exposed to either a high relative humidity environment, or fast thermal drying as primary experiments to show the power of this imaging technique to monitor and quantify the structural changes of corroded metal artifacts. This research employed a series of pre- and post-treatment tomography acquisitions (time-series) complemented by advanced image registration methods. Based on mutual information (MI) metrics, we performed rigid body and affine image registrations to meticulously account for sample repositioning challenges and variations in imaging parameters. Using non-affine local registration results, in a second step, we detected localized expansion and shrinkage in the samples attributable to imposed environmental changes. Specifically, we observed local shrinkage on the nail that was dried, mostly in their Transformed Medium (TM), the outer layer where corrosion products are cementing soil and sand particles. Conversely, the sample subjected to high relative humidity environment exhibited localized expansion, with varying degrees of change across different regions. This work highlights the efficacy of our registration techniques in accommodating manual removal or loss of extraneous material (loosely adhering soil and TM layers around the nails) post-initial tomography, successfully capturing local structural changes with high precision. Using differential analysis on the accurately registered samples we could also detect and volumetrically quantify the variation in moisture and detect changes in active corrosion sites (ACS) in the sample. These preliminary experiments allowed us to advance and optimize the application of a neutron tomography and image registration workflow for future, more advanced experiments such as humidity fluctuations, corrosion removal through micro-blasting, dechlorination and other stabilization treatments.

Ultrasound (US) of the fingers: anatomy and pathology.

The development and evolution of high-frequency probes in current ultrasound systems have enabled us to obtain more detailed information about small and superficial structures, such as the fingers, which are frequently injured in a significant portion of the population (traumatic injuries account for 28% of musculoskeletal system injuries) and can result in substantial disability for affected patients. Due to its superior accessibility, resolution, and ability to perform dynamic studies, ultrasound has become the imaging technique of choice for evaluating these conditions. It covers a range of pathologies, including tendinous, ligamentous, and articular injuries, as well as soft tissue tumors and pseudotumors, which will be described in detail in the main body of the article. However, given the complexity and small size of these structures, along with the necessity for early diagnosis to enable surgical treatment and minimize functional impairment, it is essential to be well-versed in the anatomy, examination techniques, and basic pathologies of the fingers to perform a thorough evaluation and achieve an accurate diagnosis. Therefore, the primary objective of this article is to present this content in a practical and straightforward manner, making it useful not only for radiology professionals but also for other specialists, since ultrasound is the most commonly used imaging method outside of radiology.

Modern approaches and technologies to prevent anastomotic leakage in the gastrointestinal tract

The healing of gastrointestinal anastomoses is acomplex biological process influenced by numerous factors. Various strategies to support healing and prevent anastomotic leakage (AL) exist, encompassing preoperative, intraoperative and postoperative measures. Preoperative interventions aim to optimize the patient and the tissue environment, particularly the gut microbiome. Intraoperative measures are technical in nature and include the choice of surgical access, the anastomotic technique and anastomotic reinforcement. Various procedures of the intraoperative diagnostics enable identification of such anastomoses requiring additional protective measures. Recently, indocyanine green (ICG) fluoroscopy has become established for evaluation of tissue perfusion, while newer techniques such as spectral microscopy offer promising possibilities. Postoperative diagnostic methods aim to identify potential AL as early as possible to enable initiation of therapeutic steps even before the onset of symptoms. These procedures range from various imaging techniques to innovative bioresorbable, pH-sensitive implants for early AL detection. Due to the multifactorial genesis of AL and the diverse technical possibilities, no single method will become established for prevention of AL. Instead, acombination of measures will ultimately lead to optimal anastomotic healing. The use of artificial intelligence and analyses based on the data promises a better interpretation of the vast amount of data and therefore to be able to provide general recommendations.

Contemporary insights into spinopelvic mechanics.

Understanding spinopelvic mechanics is important for the success of total hip arthroplasty (THA). Despite significant advancements in appreciating spinopelvic balance, numerous challenges remain. It is crucial to recognize the individual variability and postoperative changes in spinopelvic parameters and their consequential impact on prosthetic component positioning to mitigate the risk of dislocation and enhance postoperative outcomes. This review describes the integration of advanced diagnostic approaches, enhanced technology, implant considerations, and surgical planning, all tailored to the unique anatomy and biomechanics of each patient. It underscores the importance of accurately predicting postoperative spinopelvic mechanics, selecting suitable imaging techniques, establishing a consistent nomenclature for spinopelvic stiffness, and considering implant-specific strategies. Furthermore, it highlights the potential of artificial intelligence to personalize care.

Evaluating the effects of three anesthetic regimens on retinal structure and function in the living mouse eye using a customized bimodal OCT/ORG system

Abstract Optical coherence tomography (OCT) is a non-invasive imaging technique that generates cross-sectional images of biological tissues at millimeter-level penetration depth with micron-level resolution. In this study, we developed a custom spectral-domain OCT system equipped with a flash stimulus module for dual-modality imaging of mouse retinal structure and function. The axial resolution of the system reached ∼2.7/2 μm in air/tissue following optimization and calibration. We deployed this system to conduct in vivo OCT structural imaging and optoretinography (ORG) functional assessment of mouse retina to investigate the effects of three anesthesia regimens. Statistical analysis of the results indicates that anesthesia results in a smaller relative intensity of inner/outer segment junction and external limiting membrane and a thickening of the outer segment compared to an awake state. Meanwhile, significant differences were observed in the effects on retinal structure and function between isoflurane and tribromoethanol anesthesia, while differences between isoflurane and esketamine+xylazine groups were small. These findings suggest that the type of anesthetic should be taken into account when comparing imaging results across studies reported in the literature.

PRPH2-associated Retinal Diseases: A Systematic Review of Phenotypic Findings

PurposePRPH2-associated retinal diseases (PARD) result from pathogenic PRPH2 variants, primarily affecting photoreceptor outer segments and retinal pigment epithelium. The focus of this article is to review and discuss the phenotyping of PARD subtypes. DesignA systematic review MethodsThe review followed PRISMA 2020 guidelines with searches on PubMed, Medline, Web of Science, Google Scholar, and Cochrane Library. Eligible studies were those which discussed molecularly confirmed PARD or described associated diseases such as butterfly pattern dystrophy. Inclusion: cross-sectional, cohort, case-control studies, book chapters. Exclusion: non-English, conference papers, non-peer-reviewed, or non-full text articles. ResultsPARD is responsible for 25% of pattern dystrophy and up to 5% of inherited retinal dystrophies. There is clear evidence of phenotypic variability between individuals carrying the same pathogenic variant. Fundus autofluorescence, fluorescein angiography, optical coherence tomography, while in research adaptive optics reveal detailed phenotypic characteristics, notably in retinal pigment epithelium changes and photoreceptor disruption. The phenotypic of PARD variability presents diagnostic challenges, with phenotypic features often overlapping with other retinal diseases including age-related macular degeneration, Stargardt disease and retinitis pigmentosa. ConclusionThis review emphasizes revising diagnostic criteria by incorporating more recent imaging techniques and confirming diagnosis with the use of genetic testing. Understanding phenotypic diversity and intrafamilial variability in PARD is crucial for developing new treatments and for patient prognosis and future research should focus on larger cohorts studying genotype-phenotype correlations.

MicroRNAs in Congenital Diaphragmatic Hernia: Insights into Prenatal and Perinatal Biomarkers and Altered Molecular Pathways: microRNAs in Congenital Diaphragmatic Hernia for Pathway Analysis and Prognostic Biomarkers

Congenital diaphragmatic hernia (CDH) is characterized by a diaphragmatic defect, leading to herniation of abdominal organs into the chest, lung compression, and impaired lung development, often resulting in pulmonary hypertension and lung hypoplasia. Prenatal imaging techniques like ultrasound and MRI provide anatomical predictors of outcomes, but their limitations necessitate novel biomarkers for better prognostic accuracy. This study aims to identify unique circulating maternal, fetal, and neonatal microRNAs (miRNAs) that can distinguish CDH pregnancies from healthy controls and assess their potential as markers of disease severity. We conducted a prospective study involving third-trimester maternal blood, amniotic fluid, cord blood, and neonatal blood samples from pregnancies complicated by CDH and healthy controls. miRNA expression was analyzed using RNA-sequencing, and random forest analysis identified miRNAs distinguishing CDH survivors from non-survivors. Pathway enrichment analyses were performed to explore the biological relevance of differentially expressed miRNAs. Significant miRNA expression differences were observed between CDH and control samples across all sample types. In infant blood, 148 miRNAs were up-regulated, and 36 were down-regulated in CDH cases. Pathway analysis revealed that dysregulated miRNAs in CDH targeted pathways related to protein binding, transcription regulation, and signaling pathways implicated in pulmonary hypertension and lung hypoplasia. Random forest analysis identified miRNAs in maternal blood (miR-7850-5p_L-1R+2, miR-942-3p, and miR-197-3p) that distinguished CDH survivors from non-survivors, with an ROC area under the curve of 1.0. Circulating miRNAs in maternal blood offer promising biomarkers for predicting CDH outcomes. miRNAs from infant blood provide mechanistic insights and potential targets for therapeutic intervention in critical pathways of pulmonary hypertension and lung hypoplasia. Further studies with larger cohorts are needed to validate these findings and explore the clinical application of miRNA biomarkers in CDH management.

Que peut nous apprendre l’étude du métabolisme cérébral en TEP au 18F-FDG du syndrome de Lance-Adams ?

Lance-Adams syndrome, also known as “chronic post-anoxic myoclonus”, is a rare syndrome characterised by intention and action myoclonus following cerebral anoxia, leading to major disability. The cortical or subcortical origin of the myoclonus is still debated. Answering this question would open up new avenues of translational research to gain a better understanding of the pathophysiology of this syndrome and better guide the therapeutic management of patients. In addition to a neurological examination, the initial diagnostic work-up includes a biological work-up, electrophysiological investigations and brain imaging to rule out diGerential diagnoses. Cerebral MRI is the reference imaging technique. In the literature, more than a third of patients have a normal MRI. MRI is used to rule out a vascular cause and to look for atrophy or neuronal damage. Few data are available in the literature on the role of nuclear medicine. To date, 13 cases have been published using 18F-FDG PET and 4 using cerebral perfusion scintigraphy. Abnormalities of cortical and/or subcortical perfusion or metabolism are reported in 65% of cases; they are limited to the neocortex in 23% and aGect the cerebellum in 12% of cases. In this article, we present three patients who underwent cerebral 18F-FDG PET scans for Lance-Adams syndrome with normal MRI. The results of these examinations are discussed and compared with the data found in the literature.

Bone marrow magnetic resonance imaging (MRI): morphological and functional features from reconversion to infiltration.

Bone marrow is a dynamic organ with variable composition in relation to age or pathophysiological changes. Magnetic resonance imaging (MRI) is the technique of choice to assess the different components of the bone marrow based on the different information provided by the different characteristics of the MRI sequences. This article provides an overview of the MRI appearances of normal and abnormal bone marrow. We review the MRI features of normal developmental red marrow- to yellow-conversion, reconversion and physiologic conditions. We review the key imaging techniques used in assessing bone marrow pathology in MRI, including T1-weighted, T2-weighted, Dixon chemical shift imaging and diffusion-weighted imaging, as well as dynamic contrast-enhanced (DCE) MRI. It is discussed the bone marrow characteristics in the different morphological and functional MRI sequences from the normal or abnormal conditions such as; infiltration (metastases), proliferation [multiple myeloma (MM)], vascular edema/necrosis and postreatment changes. We show the different MRI features to differentiate physiological processes from pathological processes in order to provide effective diagnoses, as well as to evaluate the optimal therapeutic monitoring assessment. Insights from recent advancements in imaging technology and emerging MRI techniques are also discussed, providing a comprehensive overview of bone marrow MRI and its clinical implications. This review provides a useful tool for radiologist to decide normal or abnormal findings from the analysis of bone marrow MRI; in order to manage and take decisions that will depend on the imaging findings. The optimal analysis of bone marrow MRI requires knowledge of the physiology of the bone marrow to interpret properly the pathology and avoid diagnostic errors.

Nanorevolution Unleashing the Power of Nanotechnology

Abstract: Nanotechnology, the manipulation of matter at the nanoscale, has been an extraordi-nary scientific frontier that has revolutionized various fields, with one of the most promising ap-plications being in the realm of medicine. Nanomedicine, an interdisciplinary field at the intersec-tion of nanotechnology and medicine, holds tremendous potential to transform the landscape of healthcare, diagnosis, and treatment. This abstract delves into the burgeoning advancements of nanotechnology in nanomedicine, highlighting its significance, potential benefits, and ethical con-siderations. The primary focus of nanomedicine is to engineer and utilize nanoscale materials, such as nano-particles and nanostructures, to improve the effectiveness and precision of medical interventions. Nano-sized drug delivery systems can target specific cells or tissues, enhancing therapeutic out-comes and reducing side effects. These nanocarriers can penetrate biological barriers and accu-mulate at disease sites, enabling more efficient drug delivery and increasing the bioavailability of therapeutic agents. Furthermore, nanotechnology has opened new horizons in medical imaging. Nanoparticles can be engineered to be responsive to certain diseases or conditions, providing val-uable information for early detection and precise diagnosis. Novel contrast agents based on na-nomaterials have the potential to revolutionize imaging techniques, offering higher sensitivity and specificity, ultimately leading to improved patient outcomes. Beyond diagnostics and drug delivery, nanotechnology is fostering breakthroughs in regenerative medicine. Nanomaterials can act as scaffolds, guiding tissue repair and promoting cellular regen-eration. By harnessing the unique properties of nanoscale materials, tissue engineering, and organ transplantation may witness unparalleled advancements, bringing hope to countless patients awaiting life-saving treatments. However, the unprecedented potential of nanomedicine also rais-es ethical concerns that demand careful consideration. As nanotechnology progresses, concerns about the safety of nanomaterials, potential toxicity, and long-term effects must be addressed to ensure responsible and sustainable development.

Ultrasound guided procedures in the musculoskeletal system: a narrative review with illustrative examples.

Ultrasound guidance plays a pivotal role in percutaneous procedures for diagnosing and managing musculoskeletal disorders. Such procedures encompass biopsies for tumor, diagnostic aspiration and therapeutic drainage of abscesses, hematomas, cysts and fluid collections, therapeutic injections into joints, nerves, and tendons, as well as aspirations of calcium deposits and extraction of foreign bodies. This review aims to compile the most frequent ultrasound-guided procedures in the musculoskeletal system and present the state-of-the-art in current advances and evidence. We performed a literature review on interventional ultrasound in the musculoskeletal system, and included reviews, systematic reviews, meta-analysis, and clinical trials published during the last 10 years. Articles related to imaging techniques different from ultrasound, or spinal, thoracoabdominal and facial procedures were excluded. A total of 120 articles were selected and included in this review. We qualitatively synthesized the main findings and complemented the review with illustrative images from our daily practice. Most of the reviewed studies found superiority of ultrasound-guided versus landmark-guided procedures. Ultrasound was generally considered as a valuable tool for many specialists in diagnosing and treating many musculoskeletal pathologies, but some disparities in needle approaches, techniques, medication, and doses make it difficult to draw strong evidence in different clinical scenarios. Advances in ultrasound-guided procedures in the musculoskeletal system have enabled radiologists and other specialists to achieve high accuracy in diagnosing and treating various musculoskeletal conditions, including tumors, inflammatory and degenerative arthritis, tendinopathies, and bursal pathologies.

Front-Tracking and Gelation in Sessile Droplet Suspensions: What Can They Tell Us about Human Blood?

Recently developed imaging techniques have been used to examine the redistribution of human red blood cells and comparator particles dispersed in carrier fluids within evaporating droplets. We demonstrate that progressive gelation initiates along an annular front, isolating a central pool that briefly remains open to particulate advection before gelation completes across the droplet center. Transition to an elastic solid is evidenced by cracking initiating proximal to front locations. The arrested flow of cellular components, termed a "halted front", has been investigated using a time-lapse analysis "signature". The presence of a deformable biocellular component is seen to be essential for front-halting. We show a dependence of front-halt radius on cell volume-fraction, potentially offering a low-cost means of measuring hematocrit. A simple model yields an estimate of the gel zero-shear yield-stress. This approach to understanding the drying dynamics of blood droplets may lead to a new generation of point-of-care diagnostics.

Vision language models in ophthalmology.

Vision Language Models are an emerging paradigm in artificial intelligence that offers the potential to natively analyze both image and textual data simultaneously, within a single model. The fusion of these two modalities is of particular relevance to ophthalmology, which has historically involved specialized imaging techniques such as angiography, optical coherence tomography, and fundus photography, while also interfacing with electronic health records that include free text descriptions. This review then surveys the fast-evolving field of Vision Language Models as they apply to current ophthalmologic research and practice. Although models incorporating both image and text data have a long provenance in ophthalmology, effective multimodal Vision Language Models are a recent development exploiting advances in technologies such as transformer and autoencoder models. Vision Language Models offer the potential to assist and streamline the existing clinical workflow in ophthalmology, whether previsit, during, or post-visit. There are, however, also important challenges to be overcome, particularly regarding patient privacy and explainability of model recommendations.

Novel intercellular spread mode of respiratory syncytial virus contributes to neutralization escape

Developing widely used respiratory syncytial virus (RSV) vaccines remains a significant challenge, despite the recent authorization of two pre-F vaccines for elderly adults. Previous reports have suggested that even when vaccine-induced immunity generates high titers of potent neutralizing antibodies targeting the pre-F protein, it may not fully inhibit breakthrough of RSV infections. This incomplete inhibition of RSV breakthrough infections can lead to an increased risk of enhanced respiratory disease (ERD) in vaccinated individuals. The reasons why potent neutralizing antibodies cannot fully prevent RSV breakthrough infections are not yet clear. In an attempt to explain this phenomenon, we investigated the effect of potent neutralizing antibodies on the intercellular spread of RSV. Our findings indicated that a specific titer of potent neutralizing antibodies, such as 5C4, could block certain modes of intercellular spread, such as the diffusion of cell-free virions and the delivery of virions through filopodia. However, these antibodies did not fully inhibit the entire process of intercellular spread. Through the use of super-resolution imaging techniques, we observed a novel and efficient spread mode called the transition of viral materials through intercellular nanotubes (TVMIN), independent of virions and insensitive to the presence of antibodies. TVMIN allowed RSV-infected cells to directly transfer viral materials to neighboring cells via intercellular nanotubes that are rich in microfilaments. TVMIN began as early as 5 h post-infection (h.p.i.) and rapidly initiated infection in recipient cells. Our data provided new insights into the intercellular spread of RSV and might help explain the occurrence of breakthrough infections.

Contribution of 3D virtual modeling in locating hepatic metastases, particularly “vanishing tumors”: a pilot study

Aim: This article aims to explore how three dimensions (3D) virtual modeling enhances accuracy and efficiency in detecting hepatic metastases, with a specific focus on “vanishing tumors” that are difficult to detect using traditional imaging techniques. It also aims to demonstrate the potential impact of these advanced technologies on improving diagnostic and treatment strategies for patients with liver cancer. Methods: Eight patients with liver metastases from colorectal cancer were studied using magnetic resonance imaging (MRI) and 3D virtual modeling to enhance surgical planning by accurately locating lesions. The concordance between these imaging techniques and the Gold Standard was assessed using Gwet’s AC1 coefficient, with statistical analysis performed through resampling methods and non-parametric tests due to non-normal AC1 distribution. Liver segmentation was conducted semi-automatically using SurgiPrint software, which is crucial for detecting lesions undetectable post-chemotherapy. The study’s evaluation model involved questionnaires for medical professionals across four cohorts, aiming to determine the 3D model’s effectiveness in identifying lesion locations for surgery. Results: This study investigated the efficacy of 3D virtual modeling in identifying hepatic metastases, particularly comparing its accuracy with traditional MRI in locating lesions. The findings indicate that MRI generally provided better concordance with the Gold Standard for lesion localization, except for a few experienced users who had prior familiarity with the 3D models. Despite the mixed results in accuracy, the study suggests potential benefits of 3D modeling in enhancing surgical planning and execution, particularly in detecting “vanishing” liver metastases that are difficult to visualize with standard imaging techniques. The research aligns with broader evidence indicating the utility of 3D models in improving outcomes in hepatic surgery by enabling more precise resections and reducing postoperative complications. However, the study also notes the challenge of quantifying the added value of 3D modeling due to the unique nature of each surgical case and the potential bias in the user experience with the technology. Conclusion: The conclusion of this study underscores the significant potential of 3D virtual modeling in enhancing the precision of locating and resecting hepatic metastases, particularly those elusive “vanishing tumors”. This research underscores the value of integrating advanced 3D imaging techniques into surgical practice, suggesting a paradigm shift toward more accurate and less invasive liver surgeries. Future studies should aim to further quantify the benefits of 3D modeling in surgical outcomes, investigate its utility across different surgical experiences, and explore the integration of artificial intelligence (AI) to maximize its effectiveness in clinical settings.

Circle of Willis and Its Anatomical Relevance

The Circle of Willis is an arterial network located at the base of the brain, formed by the interconnection of the anterior, middle, and posterior cerebral arteries, along with the anterior and posterior communicating arteries. It connects the internal carotid arteries to the vertebral arteries, allowing the distribution of cerebral blood flow. Its significance lies in its ability to offer an alternative pathway in cases of arterial obstruction, helping to prevent cerebral ischemia. However, anatomical variations of this structure are common, and only 20% to 25% of the population has a "complete" or symmetrical configuration. Such variations can influence the risk of cerebrovascular diseases, such as stroke, as they may compromise the efficiency of the compensatory mechanism. These anatomical variations have a direct impact on the diagnosis and treatment of neurological conditions. The integrity of the Circle of Willis can influence the severity of symptoms in cases of ischemic strokes, as well as affect aneurysm formation and its clinical implications. Advances in imaging techniques, such as CT angiography and magnetic resonance imaging, have enabled more accurate diagnoses and the development of more effective treatments for conditions associated with the Circle of Willis, making its anatomical understanding essential for the prevention and management of cerebrovascular diseases.

Advancements in Imaging and Neurosurgical Techniques for Brain Tumor Resection: A Comprehensive Review

Advancements in Imaging and Neurosurgical Techniques for Brain Tumor Resection: A Comprehensive Review

Peripapillary vessels density is closely related to cerebral white matter hyperintensities: An OCTA study.

Chronic cerebral hypoperfusion triggers the development of white matter hyperintensities (WMHs), common in cerebral small vessel disease (CSVD). However, conventional imaging techniques cannot visualize cerebral small vessels. The retina, a direct extension of the central nervous system, has an unclear correlation with WMHs. This study employs Optical coherence tomographic angiography (OCTA) to investigate vascular changes in the retina and explore its correlation with WMHs, aiming to provide a new method for assessing perfusion in early ischemic brain WMHs. Forty-nine patients with WMHs were stratified into mild and moderate/severe WMHs groups based on MRI findings, utilizing the Fazekas and Scheltens scales. OCTA assessed fundus vessel microcirculation. Logistic regression analyzed the correlation between ocular fundus microcirculation and WMH severity and location. Additionally, ROC curves evaluated the diagnostic efficacy of each fundus vascular microcirculation index in determining WMH severity. After adjusting for multiple confounders, finding consistently indicated that the moderate/ severe WMHs group exhibited lower vessel density (VD) in the superior quadrant of the inner peripapillary region compared to the mild group [OR = 0.487, CI (0.255,0.929), p < 0.05]. ROC curves revealed that when combined with age, diabetes, and superior quadrant VD of the inner peripapillary region, specificity could be increased to 94.1%. Peripapillary vessel density correlates closely with the severity of cerebral WMHs. Early morphological changes due to chronic hypoperfusion may initiate from the inner layer of the optic disc, and OCTA could offer a novel method for evaluating blood perfusion in ischemic WMHs.