Relation Between Leukoaraiosis And Retinal Vessel Abnormalities

ObjectiveLeukoaraiosis (LA) is visible in a quarter of the elderly population over65years old, but the pathogenesis of LA has not yet been elucidated, ischemic demyelination and cerebral small vessel disease are two important theories to the pathogenesis of LA. According to the pathology found small vessel diseases in patients with LA, think the ischemic damage is mainly related to cerebral arteriole sclerosis. A number of studies suggest that cerebral apoplexy patients with fundus small vessel diseases and rentinopathy are similar. Retinal vessel abnormalities lesion and cerebral small vessel diseases is the common pathological basis of small vascular lesions. Small-vessel disease contributes to the pathophysiology of stroke, and retinal microvascular signs have been linked to the risk of stroke.Fundus retinal vessel abnormalities is only in circulation system, can be observed in vitro for noninvasive indexes can help us understand the the human small vascular pathological changes. Therefore, retinal vessel abnormalities pathological changes could be a hint of cerebral small vessel diseases. This study through the observation and analysis of cerebral leukoaraiosis with retinal vessel abnormalities lesion differences to non leukoaraiosis in patients, to explore whether retinal vascular lesions can be as the indicators of leukoaraiosis,comprehend the relationship between retinal vessel abnormity and the severity of leukoaraiosis, and further explore the risk factors of leukoaraiosis. ComPrehend the relationship between retinal vessel abnormity and leukoaraiosis.MethodsConsecutively collected A total of168patients between40～80years old who had admitted in the Department of Neurology, General Hospital of Beijing Military Command and could perform fundus photography examination in a sitting position, from Janunary2012to October2012.A11of them had accepted a Magnetic Resonance Imaging(MRI), T1, T2, T1weighted imaging, T2weighted imaging and Fluid attenuated inversion recovery (FLAIR), the nerve physician according to the head MRI divided them into LA group (108cases) and non LA group (60cases); All patients had both eyes fundus photography, the trained ophthalmologist being blinded to clinical details assessed the rentinopathy (Arteriovenous crossing signs, microaneurysms, waxy exudate, cotton-woll paches, and bloodspots), compared two groups of patients with the general clinical data and retinal vessel abnormalities pathological changes. The LA group according to Fazkas quantitative rating scale analysis will be divided into three groups, compare the correlation with the retinal vessel abnormalities.ResultsThe common incidences of hypertension, lacunar infarction history,serum homocysteine levels as well as plasma Creactive protein level in the leukoaraiosis groups were higher than those in the non leukoaraiosis groups, The differences were statistically significant (P<0.05or P<0.01).The incidence of arteriovenous crossing signs was70.37%(76/108) in the leukoaraiosis group were higher than38.33%in the non leukoaraiosis group (P<0.05). The incidence of the waxy exudate was was31.48%(34/108) in the leukoaraiosis group were higher than15.0%in the non leukoaraiosis group (P<0.05). There were no significant differences in microaneurysms, cotton-woll paches, and bloodspots.Binary logistic regression analysis showed that the incidence of leukoaraiosis of patients with arteriovenous crossing signs was4.14times of those without arterial crossing signs (OR=4.14,95%CI:1.67-10.28) The incidence of leukoaraiosis of patients with the waxy exudate was1.81times of those without hard exudates (OR=1.81,95%CI:0.56-5.87).The Multivariate the logistic regression analysis showed that age,hypertension and previous lacunar infarction history were the independent factors for retinal vessel abnormalities (OR=4.02,95%CI:1.59-10.13;OR=3.22,95%CI:1.93-25.87,0R=2.51,95%CI:1.75-7.42). Retinal vessel abnormalities were the independent factors for the degree of leukoaraiosis (OR=1.23,95%CI:2.87-8.13).conclusionArteriovenous crossing signs and waxy exudate are two signs in Retinal vascular lesions can be as the indicators of leukoaraiosis,and the Retinal vascular lesions can assessment the degree of leukoariosis changes as an important indicators.