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  • Potential Biomarkers of Ischemic Stroke

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
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    Journal Highlights

    Translational Vision Science & Technology
    2022;11(10):21

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    There is mounting evidence that the microvascular damage associated with small vessel disease is a major cause of ischemic stroke, but the resolution of neuroimaging techniques may not allow for direct visualization of minor changes. Little is known about the rela­tionship between ischemic stroke and abnormal OCT angiography (OCTA) findings in the setting of machine learning. Duan et al. combined OCTA and machine learning to quantitatively assess retinal microvasculature of the superficial and deep capillary plexuses. In particular, they explored geometric changes of the retinal microvasculature and the foveal avascular zone (FAZ) in patients with ischemic stroke. Their findings suggest that the FAZ axis ratio and FAZ circularity of the deep capil­lary plexus may be potential biomark­ers of ischemic stroke. Moreover, OCTA depicted distinct patterns of damage in the retinal microvascular and macular morphology for the common subtypes of ischemic stroke.

    For this study, the researchers evalu­ated 33 patients who experienced isch­emic stroke (14 nonlacunar infarctions, 19 lacunar infarctions) and 27 control participants.

    Based on OCTA, three vascular parameters were extracted and analyzed for the superficial and deep capillary plexuses: vascular area density, vascular fractal dimension, and vascular orien­tation distribution. In addition, four FAZ-related parameters were assessed for the same plexuses: area, roundness, axis ratio, and circularity. Regression analysis was performed, and odds ratios were determined.

    According to multivariate logistic re­gression analysis, factors independently linked to ischemic stroke were poor BCVA (OR, .21), high FAZ axis ratio of the deep capillary plexus (OR, 2.77), and low FAZ circularity of the deep capillary plexus (OR, .36). Low vascular orientation distribution of the superfi­cial capillary plexus correlated strongly with lacunar infarction. However, no other parameter had a significant rela­tionship to ischemic stroke or to either subtype.

    “Our study adds to the knowledge of the retinal microvasculature and FAZ in ischemic stroke and its subtypes,” said the authors. Their findings suggest that FAZ axis ratio and FAZ circularity of the deep capillary plexus may serve as potential biomarkers of ischemic stroke.

    The original article can be found here.