Retinal sublayer defect is independently associated with the severity of hypertensive white matter hyperintensity
Retinal sublayer defect is independently associated with the severity of hypertensive white matter hyperintensity
复制标题
视网膜下层缺陷与高血压白质高信号的严重程度独立相关
DOI：
10.1002/brb3.1521
复制
发表时间：
2019-12-25
影响因子：
3.1
通讯作者：
Han, Zhao
中科院分区：
文献类型：
--
作者：
Qu, Man;Kwapong, William Robert;Han, Zhao
目的探讨高血压性脑白质高强度(WMH)患者光学相干断层扫描(OCT)视网膜特定亚层厚度与Fazekas脑部磁共振成像(MRI)标志物的关系。方法88例受试者(32例健康对照和56例高血压脑白质高信号受试者)行OCT和MRI视网膜成像。采用自制算法测量视网膜神经纤维层(RNFL)、神经节细胞层和内丛状层(GCIP)的厚度。在MRI上评估白质高信号的焦点标志物，并使用Fazekas视觉分级进行分级。结果高血压WMH组RNFL层和GCIP层明显低于健康对照组(P<；0.05)。总体受试者的RNFL(Rho=-.246，p&t；.001)和GCIP(Rho=-.338，p&t；.001)与Fazekas评分呈显著正相关。在调整了眼间相关性、年龄、高血压、吸烟、体重指数和糖尿病的相关性后，统计学上的差异仍然显著(p<；0.05)。在高血压WMH患者中，在调整年龄和其他危险因素后，较高的Fazekas评分与RNFL和GCIP层变薄显著相关(p<；0.05)。结论RNFL和GCIP的视网膜变性与脑白质局灶性病变独立相关，且随病变程度加重而加重。我们认为，使用OCT对视网膜亚层的成像和测量可能为WMH的神经变性提供证据。
Purpose To investigate the association of specific retinal sublayer thicknesses on optical coherence tomography (OCT) imaging with brain magnetic resonance imaging (MRI) markers using the Fazekas scale in hypertensive white matter hyperintensity (WMH) subjects. Methods Eighty-eight participants (32 healthy controls and 56 hypertensive white matter hyperintensity subjects) underwent retinal imaging using the OCT and MRI. A custom-built algorithm was used to measure the thicknesses of the retinal nerve fiber layer (RNFL) and ganglion cell layer and inner plexiform layer (GCIP). Focal markers for white matter hyperintensities were assessed on MRI and graded using the Fazekas visual rating. Results Hypertensive WMH showed significantly reduced (p < .05) RNFL and GCIP layers when compared to healthy controls, respectively. A significant correlation was found between the RNFL (rho = -.246, p < .001) and GCIP (rho = -.338, p < .001) of the total participants and the Fazekas score, respectively. Statistical differences were still significant (p < .05) when correlations were adjusted for intereye correlation, age, hypertension, smoking, body mass index, and diabetes. Among the cases of hypertensive WMH, higher Fazekas scores were significantly associated (p < .05) with the thinning of both the RNFL and GCIP layers after adjustment of age and other risk factors. Conclusions Retinal degeneration in the RNFL and GCIP was independently associated with focal lesions in the white matter of the brain and deteriorates with the severity of the lesions. We suggest that imaging and measurement of the retinal sublayers using the OCT may provide evidence on neurodegeneration in WMH.