Associations of macular microvascular parameters with cerebral small vessel disease in rural older adults: A population-based OCT angiography study

Zhe Xu; Yi Dong; Yongxiang Wang; Lin Song; Sijie Niu; Shanshan Wang; Mingqing Zhao; Jiafeng Wang; Lin Cong; Xiaojuan Han; Tingting Hou; Shi Tang; Qinghua Zhang; Yifeng Du; Chengxuan Qiu

doi:10.3389/fneur.2023.1133819

Associations of macular microvascular parameters with cerebral small vessel disease in rural older adults: A population-based OCT angiography study

Front Neurol. 2023 Mar 16:14:1133819. doi: 10.3389/fneur.2023.1133819. eCollection 2023.

Authors

Zhe Xu¹, Yi Dong^{1

2

3}, Yongxiang Wang^{1

2

3}, Lin Song^{1

2

3}, Sijie Niu⁴, Shanshan Wang^{1

2

3}, Mingqing Zhao², Jiafeng Wang¹, Lin Cong^{1

2

3}, Xiaojuan Han^{1

2

3}, Tingting Hou^{1

2

3}, Shi Tang^{1

2

3}, Qinghua Zhang^{1

2

3}, Yifeng Du^{1

2

3}, Chengxuan Qiu^{1

5}

Affiliations

¹ Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.
² Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
³ Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China.
⁴ Shandong Provincial Key Laboratory of Network Based Intelligent Computing, School of Information Science and Engineering, University of Jinan, Jinan, Shandong, China.
⁵ Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.

Abstract

Objective: To explore the associations of macular microvascular parameters with cerebral small vessel disease (CSVD) in rural-dwelling older adults in China.

Methods: This population-based cross-sectional study included 195 participants (age ≥ 60 years; 57.4% women) in the optical coherence tomographic angiography (OCTA) sub-study within the Multimodal Interventions to delay Dementia and disability in rural China (MIND-China). Macular microvascular parameters were measured using the OCTA. We automatically estimated volumes of gray matter, white matter, and white matter hyperintensity (WMH), and manually assessed numbers of enlarged perivascular spaces (EPVS) and lacunes on brain magnetic resonance imaging. Data were analyzed with the general linear models.

Results: Adjusting for multiple confounders, lower vessel skeleton density (VSD) and higher vessel diameter index (VDI) were significantly associated with larger WMH volume (P < 0.05). Lower VSD and foveal density-300 (FD-300) of left eye were significantly associated with lower brain parenchymal volume (P < 0.05). In addition, lower areas of foveal avascular zone (FAZ) and FD-300 of left eye were significantly associated with more EPVS (P < 0.05). The associations of abnormal macular microvascular parameters with WMH volume were evident mainly among females. Macular microvascular parameters were not associated with lacunes.

Conclusion: Macular microvascular signs are associated with WMH, brain parenchymal volume, and EPVS in older adults. The OCTA-assessed macular microvascular parameters can be valuable markers for microvascular lesions in the brain.

Keywords: cerebral small vessel disease; macular microvascular signs; magnetic resonance imaging; optical coherence tomography angiography; population-based study.

Grants and funding

MIND-China was supported in part by grants from the National Natural Science Foundation of China (Grants Nos. 82171175, 81861138008, and 81772448), the Alzheimer's Association Grant (Grant No. AACSFD-22-922844), the National Key R&D Program of China Ministry of Sciences and Technology (Grant No. 2017YFC1310100), the Natural Science Foundation of Shandong Province (Grant No. ZR2021MH005), the Academic Promotion Program of Shandong First Medical University (Grant No. 2019QL020), the Integrated Traditional Chinese and Western Medicine Program in Shandong Province (Grant No. YXH2019ZXY008), and the Brain Science and Brain-like Intelligence Technology Research Projects of China (Grant Nos. 2021ZD0201801 and 2021ZD0201808). LC received grants from the Shandong Provincial Key Research and Development Program (Grant No. 2021LCZX03). CQ received grants from the Swedish Research Council (Grant Nos. 2017-05819 and 2020-01574), the Swedish Foundation for International Cooperation in Research and Higher Education (Grant No. CH2019-8320), and Karolinska Institutet (Grant Nos. 2018-01854 and 2020-01456), Stockholm, Sweden. The funding agency had no role in the study design, data collection and analysis, the writing of this manuscript, and in the decision to submit the work for publication.