Fractal analysis of retinal vessels suggests that a distinct vasculopathy causes lacunar stroke

被引:128
作者
Doubal, F. N. [1 ]
MacGillivray, T. J. [2 ]
Patton, N. [4 ]
Dhillon, B.
Dennis, M. S.
Wardlaw, J. M. [3 ]
机构
[1] Univ Edinburgh, Div Clin Neurosci, Western Gen Hosp, Edinburgh EH4 2XU, Midlothian, Scotland
[2] Univ Edinburgh, Wellcome Trust Clin Res Facil, Edinburgh EH4 2XU, Midlothian, Scotland
[3] Univ Edinburgh, SFC Brain Imaging Ctr, Edinburgh EH4 2XU, Midlothian, Scotland
[4] Manchester Royal Eye Hosp, Dept Vitreoretinal Surg, Manchester, Lancs, England
基金
英国惠康基金; 英国医学研究理事会;
关键词
ABNORMALITIES; RETINOPATHY; CLASSIFICATION; DISEASE; RISK;
D O I
10.1212/WNL.0b013e3181d7d8b4
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives: Lacunar strokes account for 25% of all ischemic strokes and may represent the cerebral manifestation of a systemic small vessel vasculopathy of unknown etiology. Altered retinal vessel fractal dimensions may act as a surrogate marker for diseased cerebral vessels. We used a cross-sectional study to investigate fractal properties of retinal vessels in lacunar stroke. Methods: We recruited patients presenting with lacunar stroke and patients with minor cortical stroke as controls. All patients were examined by a stroke expert and had MRI at presentation. Digital retinal photographs were taken of both eyes. Monofractal and multifractal analyses were performed with custom-written semiautomated software. Results: We recruited 183 patients. Seventeen were excluded owing to poor photographic quality, leaving 166 patients (86 with lacunar and 80 with cortical stroke). The mean age was 67.3 years (SD 11.5 years). The patients with lacunar stroke were younger but the prevalence of diabetes, hypertension, and white matter hyperintensities did not differ between the groups. The mean Dbox (monofractal dimension) was 1.42 (SD 0.02), the mean D0 (multifractal dimension) 1.67 (SD 0.03). With multivariate analysis, decreased Dbox and D0 (both representing decreased branching complexity) were associated with increasing age and lacunar stroke subtype after correcting for hypertension, diabetes, stroke severity, and white matter hyperintensity scores. Conclusions: Lacunar stroke subtype and increasing age are associated with decreased fractal dimensions, suggesting a loss of branching complexity. Further studies should concentrate on longitudinal associations with other manifestations of cerebral small vessel disease. Neurology (R) 2010;74:1102-1107
引用
收藏
页码:1102 / 1107
页数:6
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