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Publications

Journal Article Ahead of print

PubMed: 40770920 DOI: 10.1177/0271678X251366079

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

J Cereb Blood Flow Metab

Authors: Gordon W Blair, Ian J C MacCormick, Sarah McGrory, Tom MacGillivray, Iona Hamilton, Yulu Shi, Francesca Chappell, Michael J Thrippleton, Michael S Stringer, Fergus Doubal, Joanna M Wardlaw

Affiliations

  • Centre for Clinical Brain Sciences, University of Edinburgh, UK. Department of Stroke and Medicine for the Elderly, Royal Infirmary Edinburgh, UK.
  • Centre for Clinical Brain Sciences, University of Edinburgh, UK.
  • Robert O Curle Ophthalmology Suite, Institute for Regeneration and Repair, University of Edinburgh, UK.
  • Row Fogo Centre for Research into Ageing and the Brain, University of Edinburgh, UK.
  • Institute for Adaptive and Neural Computation, University of Edinburgh, UK.
  • Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, UK.
  • Edinburgh Imaging, University of Edinburgh, UK.
  • Centre for Clinical Brain Sciences, University of Edinburgh, UK. Row Fogo Centre for Research into Ageing and the Brain, University of Edinburgh, UK. UK Dementia Research Institute Centre, University of Edinburgh, UK. Edinburgh Imaging, University of Edinburgh, UK.
  • UK Dementia Research Institute Centre, University of Edinburgh, UK.

Abstract

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.

MeSH

White Matter, Brain, Magnetic Resonance Imaging, Inhalation, Venules, Retinaldehyde, Cerebral Small Vessel Diseases, Arterioles