Association Of Retinal Vessel Diameter And Bifurcation Angle With Ischemic Stroke

BackgroundIschemic stroke is the most common type of stroke,early diagnosis and treatment of ischemic stroke can reduce the morbidity and mortality of patients.Retinal blood vessels have the same embryonic origin,anatomical structure and physiological and pathological properties as cerebral blood vessels,and can be used as important clues to study brain microcirculation and predict the occurrence of stroke.It is of profound significance to establish reference values of relevant retinal vascular parameters,analyze the influencing factors of retinal blood vessels,discover potential research problems and clinical significance,and explore the correlation between retinal blood vessel diameter and bifurcation angle and ischemic stroke,for the occurrence of stroke provides a reference basis.ObjectiveTo describe the parameters of retinal vessel diameter and bifurcation angle in ischemic stroke patients and healthy individuals.To analyze the effect of relevant confounding factors on retinal vessel diameter and discuss possible related mechanisms.To investigate the correlation of retinal vessel diameter and bifurcation angle with ischemic stroke.MethodsA total of 208 patients（413 eyes）with ischemic stroke and 64 cases（128 eyes）without stroke as control,admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2019 to June 2020,were recruited in the study.The fundus photos of the subject’s eyes were taken with the optic disc as the center and areas of 1.5 optic disc diameter（papillary diameter,PD）from the edge of the optic disc.Diameters for the retinal vessels,central retinal artery equivalent（CRAE）,central retinal vein equivalent（CRVE）and the arteriovenous ratio（AVR）were measured and calculated using IVAN（Integrative Vessel Analysis）,a semi-automatic software,and the bifurcation angle of retinal vessels,the superior temporal artery,inferior temporal artery and their accompanying veins were measured by software Photoshop 8.0.Following comparison of the indexes between the two groups.Multivariate linear regression analysis was performed on the influencing factors of retinal blood vessel diameter,and the relationship between retinal blood vessel diameter and gender,age,hypertension,smoking,drinking,and dyslipidemia was discussed.logistic regression model was established to explore the association of retinal vessel diameter,bifurcation angle and clinical risk factors with ischemic stroke.Results1.Compared with the control group（155.06 ± 13.37μm,220.53 ± 15.93μm）,the CRAE and CRVE of the stroke group（141.24 ± 16.01μm,225.67 ± 20.73μm）showed significant contraction and expansion（P<0.05）,accompanied by AVR（0.63±0.08）was significantly lower than the control group（0.71±0.07）（P<0.05）.2.The first-order bifurcation angles（84.65±20.00°,81.10±18.81°,88.45±17.84°,86.96±16.87°）of the retinal superior and inferior temporal arteries and veins in the stroke group were significantly greater than those in the control group（73.70 ±19.49°,69.68±17.47°,76.42±16.05°,79.02±16.38°）（all P<0.05）.3.The interval of the intersection between the stroke group and the control group:CRAE is 141.69-157.25μm,CRVE is 204.94-236.46μm,AVR is 0.64-0.71,and superior temporal artery bifurcation angle is 64.65-93.19°,The bifurcation angle of the inferior temporal artery was 70.61-92.47°,the bifurcation angle of the superior temporal vein was62.29-87.15°,and the bifurcation angle of the inferior temporal vein was 70.09-95.40°.4.Multiple linear regression analysis found that age,gender,dyslipidemia and smoking had no significant effect on CRAE and CRVE.Blood pressure was independently negatively correlated with CRAE,and alcohol consumption was independently positively correlated with CRVE.5.Logistic regression analysis showed that after excluding gender,age,history of hypertension,smoking history and drinking history,increases in CRVE,bifurcation angle of superior and inferior temporal artery and vein,and the decrease of CRAE,were significantly associated with the occurrence of ischemic stroke（P<0.05）.Conclusion1.Decreased CRAE,increased CRVE,and increased retinal vascular bifurcation angle are risk factors for ischemic stroke,and may have certain predictive value for ischemic stroke.2.The risk of ischemic stroke increased when the CRAE value range is（141.69-157.25μm）,the CRVE value range is（204.94-236.46μm）,the AVR is（0.64-0.71）,superior temporal artery bifurcation angle is（64.65-93.19 °）,inferior temporal artery bifurcation angle is（70.61-92.47 °）,superior temporal vein bifurcation angle is（62.29-87.15°）,and inferior temporal vein bifurcation angle is（70.09-95.40°）.