眼底照相与光学相干断层扫描血管成像测量的视网膜血管参数与脑小血管疾病的相关性OA

Objective To explore the correlation between retinal vascular parameters measured by fundus photography and optical coherence tomography angiography(OCTA)and cerebral small vessel disease(CSVD).Methods A total of 82 patients with CSVD who were admitted to the Department of Neurology of Shenyang Fourth People's Hospital from August 2022 to December 2024 were enrolled as the observation group,and 60 non-CSVD patients during the same period were selected as the control group.The general data of the two groups were compared.Relevant parameters of fundus photography,including central retinal vein equivalent,central retinal artery equivalent,arteriovenous ratio(AVR),simple tortuosity of retinal artery(sTORTa),curvature tortuosity of retinal artery(cTORTa),simple tortuosity of retinal vein(sTORTv),and curvature tortuosity of retinal vein(cTORTv),were compared between the two groups.Additionally,parameters of OCTA,such as the foveal avascular zone(FAZ)area,blood flow density of the superficial capillary plexus(SCP),deep capillary plexus(DCP),and choriocapillaris(CC),as well as choroidal vascular volume(CVV)and choroidal vascular index(CVI),were also compared.Univariate and multivariate logistic regression analyses were performed to explore the association between each parameter and CSVD,and receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of the parameters.Results The AVR in the observation group was lower than that in the control group,while the proportions of sTORTa,cTORTa,sTORTv,cTORTv,microaneurysms,and arteriovenous crossing signs were higher(P<0.05).The difference in the severity of retinal arteriosclerosis between the two groups was statistically significant(P<0.05).The FAZ area in the observation group was larger than that in the control group,whereas the whole retinal capillary plexus perfusion density,SCP perfusion density,DCP perfusion density,CC perfusion density,CVV,and CVI were lower,with statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that AVR,whole retinal capillary plexus perfusion density,SCP perfusion density,DCP perfusion density,CC perfusion density,CVV,and CVI were independent protective factors for CSVD.The severity of retinal arteriosclerosis(OR=2.692,95%CI:1.059-3.771),sTORTa(OR=1.599,95%CI:1.046-1.885),cTORTa(OR=1.746,95%CI:1.286-1.805),sTORTv(OR=2.108,95%CI:1.559-2.736),cTORTv(OR=2.159,95%CI:1.766-2.845),microaneurysms(OR=1.096,95%CI:1.112-1.886),arteriovenous crossing signs(OR=2.660,95%CI:1.375-3.046),and FAZ area(OR=2.831,95%CI:1.238-6.472)were independent risk factors for CSVD(P<0.05).The areas under the curve for predicting CSVD by fundus photography alone,OCTA alone,and their combination were 0.722,0.760,and 0.889,respectively.The combined prediction was significantly superior to fundus photography or OCTA alone(P<0.001).Conclusion Multiple retinal vessel-related parameters derived from fundus photography and OCTA are correlated with CSVD.Among these parameters,AVR and whole retinal capillary plexus perfusion density are independent protective factors,while the severity of retinal arteriosclerosis and FAZ area are independent risk factors.The combined application of these two examinations yields high diagnostic value for CSVD.