Fractal analysis of retinal vessels suggests that a distinct vasculopathy causes lacunar stroke
Fractal analysis of retinal vessels suggests that a distinct vasculopathy causes lacunar stroke
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DOI：
10.1212/wnl.0b013e3181d7d8b4
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发表时间：
2010-04-06
期刊：
影响因子：
9.9
通讯作者：
Wardlaw, J. M.
中科院分区：
文献类型：
--
作者：
Doubal, F. N.;MacGillivray, T. J.;Wardlaw, J. M.
目的：腔隙性卒中占所有缺血性卒中的25%，可能代表病因不明的全身性小血管血管病变的脑部表现。改变的视网膜血管分形维数可以作为患病脑血管的替代标记。我们使用了一个横断面研究，探讨视网膜血管的分形特性，在腔隙性stroke.Methods：我们招募患者提出的腔隙性中风和轻微的皮质中风患者作为对照。所有患者均由卒中专家进行检查，并在就诊时进行MRI检查。拍摄双眼的数字视网膜照片。单分形和多重分形分析进行了定制的半自动software.Results：我们招募了183例患者。17例因影像质量差而被排除，剩下166例患者（86例腔隙性脑卒中，80例皮质性脑卒中）。平均年龄为67.3岁（SD 11.5岁）。腔隙性脑卒中患者较年轻，但糖尿病、高血压和白色高信号的患病率在两组之间没有差异。平均Dbox（单分形维数）为1.42（SD 0.02），平均D 0（多重分形维数）为1.67（SD 0.03）。与多变量分析，减少Dbox和D 0（都代表分支复杂性降低）与年龄增加和腔隙性中风亚型校正后的高血压，糖尿病，中风的严重程度，和白色高信号scores.Conclusions：腔隙性中风亚型和年龄增加与分形维数降低，表明分支复杂性的损失。进一步的研究应集中在与其他表现的脑小血管疾病的纵向联系。神经病学（R）2010;74：1102-1107
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