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Retinal vascular reactivity is associated with white matter hyperintensities and dysfunctional cerebrovascular reactivity in cerebral small vessel disease

Title: Retinal vascular reactivity is associated with white matter hyperintensities and dysfunctional cerebrovascular reactivity in cerebral small vessel disease
Authors: Blair, Gordon W; MacCormick, Ian J C; McGrory, Sarah; MacGillivray, Tom; Hamilton, Iona; Shi, Yulu; Chappell, Francesca; Thrippleton, Michael J; Stringer, Michael S; Doubal, Fergus; Wardlaw, Joanna M
Source: Journal of Cerebral Blood Flow & Metabolism ; volume 45, issue 12, page 2301-2315 ; ISSN 0271-678X 1559-7016
Publisher Information: SAGE Publications
Publication Year: 2025
Description: Cerebral small vessel disease (cSVD) is characterised by white matter hyperintensities (WMH) and contributes to stroke and dementia. Cerebrovascular reactivity (CVR) declines with worsening cSVD but estimates of CVR from brain scans give limited information about the coordination of individual arterioles or venules. Retinovascular reactivity can provide separate data about arterioles and venules, but it is not known if retinovascular reactivity correlates with CVR in people with cSVD. We aimed to assess retinal vascular reactivity in people with cSVD and explore associations with WMH and CVR in a cross-sectional study. Participants had retinal photographs and magnetic resonance brain imaging (MRI) before and during inhalation of 6% CO 2 in air. We recruited 60 participants. 48 provided analysable retinal vessel reactivity data. Retinal arteriole/venule ratio was inversely related to WMH severity (adjusted R2 = 0.47 β–5.2 95%CI–7.9 to −2.5) and directly related to CVR (adjusted R2 = 0.21 β0.15 95%CI 0.04 to 0.25). In general, participants whose arteriole/venule ratio increased with CO 2 had milder WMH and higher (better) CVR, while participants whose arteriole/venule ratio decreased had more severe WMH and lower (worse) CVR. Retinovascular reactivity to CO 2 inhalation in people with cSVD suggests loss of normal arteriovenous coordination and inefficient perfusion of the capillary bed.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1177/0271678x251366079
DOI: 10.1177/0271678X251366079
Availability: https://doi.org/10.1177/0271678x251366079; https://journals.sagepub.com/doi/pdf/10.1177/0271678X251366079; https://journals.sagepub.com/doi/full-xml/10.1177/0271678X251366079
Rights: https://creativecommons.org/licenses/by/4.0/ ; https://journals.sagepub.com/page/policies/text-and-data-mining-license
Accession Number: edsbas.C94CFFD2
Database: BASE