| Objectives Optical coherence tomography angiography(OCTA)was used to monitor the characteristics of ocular microcirculation changes in patients with ischemic stroke.We analyzed the correlation between the characteristics of ocular microcirculation changes and the occurrence of ischemic stroke ischemic stroke,explored the possible early ocular warning indicators of ischemic stroke,and established a disease risk prediction model.Methods A cross-sectional study was conducted between 90 ischemic stroke individuals(experimental group)and 58 healthy individuals(control group).We compared the general characteristics and four ocular microcirculation blood flow indicators,including the area of the retinal foveal avascular area(FAZ),superficial retinal capillary density(SCP),deep retina capillary density(DCP),choroidal capillaries density(CC).We used the multivariate linear regression analysis to find the independent risk factors affecting ocular microcirculation in patients with ischemic stroke.And we used multivariate Logistic regression analysis to explored the possible early ocular warning indicators of ischemic stroke,established a disease risk prediction model,and protracted the nomogram,ROC curve,calibration curve and decision curve analysis curve of the model.Results1.We fond that there were significant differences in age,sex,smoking history,hypertension,hyperlipidemia,and other atherosclerosis-related diseases history between the two groups(P<0.05),while there were no significant differences in diabetes and alcohol consumption(P>0.05).2.We fond that there were significant differences in the area of FAZ,SCP,DCP and CC between the two groups(P<0.05).Compared with the control group,the area of FAZ in the experimental group increased significantly: the area of FAZ in the control group is 0.3453±0.1183 mm2 and the area of FAZ in the experimental group is 0.4757±0.1214 mm2;SCP was significantly reduced: the SCP in the control group is 0.4895(0.4524,0.5211)mm2 and the SCP in the experimental group is0.4069(0.3428,0.4739)mm2;DCP was significantly reduced: the DCP in the control group is 0.3759(0.3525,0.4056)mm2 and the DCP in the experimental group is 0.3301(0.2790,0.3730)mm2;CC was significantly reduced: the CC in the control group is 0.4024±0.4174 mm2 and the CC in the experimental group is0.3625±0.5192 mm2.After adjusted the two variables of age and sex,we fond that the area of FAZ,SCP,DCP and CC were still associated with the occurrence of ischemic stroke(P<0.05);further corrected the age,sex,smoking history,alcohol history,hypertension history,hyperlipidemia history,diabetes history,and other atherosclerosis-related diseases hisory,we fond that the area of FAZ,SCP,DCP and CC were still associated with the occurrence of ischemic stroke(P<0.05).3.We used multivariate linear regression results to find that the age of the experimental group was independently negatively correlated with SCP,DCP and CC(P<0.05),and the correlation coefficients were-0.004,-0.003 and-0.002.We also fond the type of ischemic stroke was independently positively correlated with CC(P<0.05),and the correlation coefficient was 0.023.On the contrary,we fond that there were no significant effects in the type of ischemic stroke,the number of focis and the degree of carotid artery stenosis on the area of FAZ,SCP and DCP(P>0.05),and the number of focis and carotid artery stenosis on CC were not significant effects,too(P>0.05).4.The outcomes of univariate logistic regression analysis showed that there were significant differences in age,sex,hypertension history,the area of FAZ,SCP,DCP and CC between the two groups(P<0.05),while there were no significant differences in smoking history,alcohol history,diabetes history,hyperlipidemia history,and other atherosclerosis-related diseases history(P>0.05).The results of multivariate logistic regression analysis showed that there were significant differences in gender,hypertension history,FAZ area and SCP between the two groups(P<0.05),while there were no significant differences in age,DCP and CC(P>0.05).5.We build a disease risk prediction model of ischemic stroke which based on ocular microcirculation indicators,and protracthed the nomogram,ROC curve,calibration curve and decision curve analysis curve.Conclusions1.We fond that the changes of the area of FAZ,SCP,DCP and CC have a strong correlation with the occurrence of ischemic stroke,which suggested that monitoring the changes of ocular microcirculation blood flow with OCTA can provide a "new visual window" for ischemic stroke research and early disease risk prediction.2.In patients with ischemic stroke,some fundus microcirculation indexes have more severe changes in advanced age and lacunar cerebral infarction,indicating that the probability of ischemic ophthalmopathy in this part of the patient was relatively increased,and early fundus screening was required in this part of the patient.3.We fond that gender,hypertension history,the area of FAZ and SCP were the independent risk factors for ischemic stroke,which showed that this ocular microcirculation indicators have a certain early warning value for ischemic stroke.Our study initially established a disease risk prediction model which based on the four indicators,and this model can providea new ideas and directions for clinical early warning or screening of the disease. |
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