Ocular Fundus Photography as a Tool to Study Stroke and Dementia
Ocular Fundus Photography as a Tool to Study Stroke and Dementia
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DOI：
10.1055/s-0035-1563570
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发表时间：
2015-10-01
影响因子：
2.7
通讯作者：
Wong, Tien Y.
中科院分区：
文献类型：
--
作者：
Cheung, Carol Y.;Chen, Christopher;Wong, Tien Y.
虽然脑小血管疾病与中风和痴呆有关，但由于目前神经成像技术的局限性，很难实现对脑小血管变化(如脑小动脉狭窄、微血管曲折、血脑屏障损害、毛细血管微动脉瘤)的在体可视化。由于视网膜和大脑具有与脑小血管相似的胚胎起源、解剖特征和生理特性，视网膜血管为研究活体脑小血管疾病的相关性和后果提供了一个独特的、容易获得的窗口。利用眼底照相技术可以对视网膜微血管进行可视化、量化和无创监测。最近的临床和基于人群的研究表明，眼底照相所见的视网膜血管变化与中风和痴呆之间存在密切联系，这表明眼底照相可能为微血管疾病对中风和痴呆症的贡献提供见解。在本文中，我们总结了视网膜血管改变的现有知识，如视网膜病变、中风和痴呆时视网膜血管测量的变化，以及脑小血管疾病的亚临床标志物，并讨论了这些发现在神经病学中可能的临床意义。研究视网膜血管的病理变化可能有助于了解各种脑血管疾病的病因，因此眼底照相具有潜在的临床应用价值。
Although cerebral small vessel disease has been linked to stroke and dementia, due to limitations of current neuroimaging technology, direct in vivo visualization of changes in the cerebral small vessels (e.g., cerebral arteriolar narrowing, tortuous microvessels, blood-brain barrier damage, capillary microaneurysms) is difficult to achieve. As the retina and the brain share similar embryological origin, anatomical features, and physiologic properties with the cerebral small vessels, the retinal vessels offer a unique and easily accessible "window" to study the correlates and consequences of cerebral small vessel diseases in vivo. The retinal microvasculature can be visualized, quantified and monitored noninvasively using ocular fundus photography. Recent clinic- and population-based studies have demonstrated a close link between retinal vascular changes seen on fundus photography and stroke and dementia, suggesting that ocular fundus photography may provide insights to the contribution of microvascular disease to stroke and dementia. In this review, we summarize current knowledge on retinal vascular changes, such as retinopathy and changes in retinal vascular measures with stroke and dementia as well as subclinical makers of cerebral small vessel disease, and discuss the possible clinical implications of these findings in neurology. Studying pathologic changes of retinal blood vessels may be useful for understanding the etiology of various cerebrovascular conditions; hence, ocular fundus photography can be potentially translated into clinical practice.