Retinal Vascular Calibers Associate Differentially With Cerebral Gray Matter and White Matter Atrophy
Retinal Vascular Calibers Associate Differentially With Cerebral Gray Matter and White Matter Atrophy
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DOI：
10.1097/wad.0b013e31829344ed
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发表时间：
2013-10-01
影响因子：
2.1
通讯作者：
Ikram, Mohammad A.
中科院分区：
文献类型：
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作者：
Ikram, Mohammad K.;de Jong, Frank J.;Ikram, Mohammad A.
脑小血管疾病被认为是脑萎缩的原因之一，但目前尚不清楚它对灰质和白质萎缩的影响是否有差异。视网膜血管为体内研究脑血管疾病提供了一种直接的测量方法。在以人群为基础的鹿特丹研究的1065人（平均年龄67.5岁，51%为女性）队列中，我们分别调查了视网膜血管直径与脑萎缩、灰质和白质萎缩的关系。在数字化眼底透明片上半自动测量视网膜小动脉和静脉直径。利用MRI扫描的自动量化，我们获得了全脑体积以及灰质和白质的体积。窄动脉和宽静脉直径都与较小的脑容量相关，彼此独立。这些关联主要是由较小的白质体积驱动的，而灰质体积没有关联。心血管危险因素的调整降低了结果，但静脉直径较宽仍与白质体积较小显著相关。我们的数据提供了脑小血管疾病主要通过影响脑白质导致脑萎缩的证据。
Cerebral small-vessel disease is thought to contribute to brain atrophy, but it remains unclear whether it affects the gray matter and white matter atrophy differentially. Retinal vessels provide a direct measure to study cerebral small-vessel disease in vivo. In a cohort of 1065 persons (mean age, 67.5 y and 51% women), from the population-based Rotterdam Study, we investigated how retinal vascular calibers relate to brain atrophy and to gray matter and white matter atrophy separately. Retinal arteriolar and venular calibers were semiautomatically measured on digitized fundus transparencies. Using automated quantification of MRI scans, we obtained whole-brain volume and volumes of gray matter and white matter. Both narrower arteriolar and wider venular calibers were associated with smaller brain volume, independent from each other. These associations were primarily driven by smaller white matter volume, whereas no associations were seen for gray matter volume. Adjustments for cardiovascular risk factors attenuated the results, but wider venular caliber remained borderline significantly associated with smaller white matter volume. Our data provide evidence that cerebral small-vessel disease contributes to brain atrophy primarily by affecting the cerebral white matter.