Correlation Analysis Between Retinal Vascular Disease In Fundus And The Degree And Location Of Cerebral Microbleeds

Purpose:To investigate the correlation between the degree and location of CMBs and retinal vascular lesions in fundus,and to analyze the risk factors for CMBs.The purpose of this study is to provide a basis for fundus retinal vascular lesions to reflect cerebral microbleeds,hoping to delay the occurrence and development of cerebral microbleeds by controlling the risk factors.Methods:A total of 101 patients with cerebral small vessel disease who were hospitalized in the Department of Neurology,the First Affiliated Hospital of Hebei North University from September 2021 to September 2022 and were able to participate in head magnetic resonance imaging and fundus photography were selected.The general clinical data of the patients were collected,including age,history of smoking,history of hypertension,history of diabetes,Triglyceride(TG),Total Cholesterol(TC),Low Density Lipoprotein-Cholesterol(LDL-C).High Density Lipoprotein-Cholesterol(HDL-C),creatinine,uric acid,urea,hypersensitive c-reactive protein(hs-CRP),and homocysteine(Hcy).All patients underwent fundus photography and T1 WI,T2WI,FLAIR,DWI,SWI and MRA examinations.Sixty-four patients with retinal vascular disease were divided into grade Ⅰ,grade Ⅱ,grade Ⅲ and grade Ⅳ.According to the results of brain magnetic resonance examination of 101 patients,they were divided into CMBs group(54 cases)and non-CMBs group(47 cases).According to the degree of cerebral microbleeds,42 patients with fundus retinal vascular disease and cerebral microbleeds were divided into mild group(12 cases),moderate group(16 cases)and severe group(14 cases).According to the location of CMBs,the patients were divided into lobar group(11 cases),deep group(14 cases)and mixed group(17 cases).IBM SPSS 25.0Chinese version software was used for all data statistical analysis.Results:1.By comparing the CMBs group with the non-CMBs group,it was found that there were statistically significant differences in age ≥60 years(P = 0.001),hypertension(P < 0.001),urea(P = 0.047),Hcy(P < 0.001)and hs-CRP(P < 0.001).There was no significant difference in diabetes,smoking,TG,TC,LDL-C,HDL-C,creatinine and uric acid between the two groups(P > 0.05).2.Taking CMBs group and non-CMBs group as dependent variable,age ≥60 years old,hypertension,urea,Hcy and hs-CRP as independent variables,multivariate analysis showed that age ≥60 years old(OR=5.54;95% CI: 1.877 ～ 16.35;P = 0.002),hypertension(OR=6.033;95% CI:2.052 ～ 17.734;P = 0.001),Hcy(OR=1.086;95% CI: 1.005 ～ 1.174;P =0.036),hs-CRP(OR=1.594;95% CI: 1.008 ～ 2.522;P = 0.046)were the independent risk factors for CMBs.3.Comparing the incidence of different grades of fundus retinal vascular disease between the CMBs group and the non-CMBs group,it was found that the incidence of grade Ⅱ fundus retinal vascular disease in the CMBs group was higher than that in the non-CMBs group(64.3%vs31.8%),and the difference was statistically significant(P<0.05).The results indicate that grade Ⅱ retinal vasculopathy is more common in the CMBs group than in the non-CMBs group.Statistical analysis showed that there was no significant difference in the incidence of grade Ⅰ(P = 0.155),gradeⅢ(P = 0.063)and grade Ⅳ(P = 0.466)between the two groups.4.Statistical analysis was performed between different grades of retinal vascular lesions and different degrees of CMBs.The results showed that there was a statistically significant difference between different grades of retinal vascular lesions and CMBs degree(P < 0.05),and the degree of cerebral microbleeds was positively correlated with the grade of retinal vascular lesions(r = 0.401).5.Fisher’s exact test was used to analyze the difference between different grades of fundus retinal vascular lesions and CMBs at different locations.The results showed that there were statistically significant differences in the classification of fundus retinal vascular lesions among the lobed CMBs group,deep CMBs group and mixed CMBs group(P < 0.05).However,Bonferroni method was used for multiple comparisons,and it was found that there was no statistically significant difference in the classification of retinal vascular lesions in the fundus between the lobar CMBs group and the deep CMBs group,the deep CMBs group and the mixed CMBs group,and the mixed CMBs group and the lobar CMBs group.Conclusion:1.Age ≥60 years old,hypertension,hypersensitive C-reactive protein and homocysteine were independent risk factors for CMBs.2.Among the different grades of fundus retinal vasculopathy,fundus retinal vascular disease grade Ⅱ may indicate the occurrence of CMBs.3.The higher the grade of retinal vascular lesions in fundus,the more severe the degree of cerebral microbleeds.