허혈성 뇌졸중 환자에서 망막 미세혈관 변성의 의의

초록

Background: Retinal microvascular abnormalities reflect cerebral microvascular changes. However, there is few clinical data on the relationship between retinal icrovascular changes and intracranial arterial stenosis or stroke subtypes. We examined the association between white matter changes (WMCs) or large artery stenosis and retinal microvascular changes, stroke subtypes. Methods: We investigated demographic features, retinal microvascular changes, intracranial large arterial stenosis, WMCs and stroke subtypes in 100 acute ischemic stroke patients over 2 years who had taken retinal photography and underwent brain MRI with MR angiography. Retinal photography was evaluated for specific retinal microvascular change by grader using standardized protocol. Intracranial arterial stenosis was defined by MR angiography. WMCs were coded from 1 for normal to 8 for most severe degree. And we defined “White matter lesion” as grade 3 or more. Stroke subtypes were classified by TOAST criteria. Results: Among the retinal microvascular changes, retinal hemorrhage, arteriovenous nicking, focal and generalized arteriolar narrowing and venous congestion were significantly correlated with intracranial large arterial stenosis. There was no relationship between the retinal microvascular changes and stroke subtypes. And only focal arteriolar narrowing was significantly correlated with WML. Conclusions: Retinal microvascular changes seen in patients with ischemic stroke were related to intracranial large arterial stenosis. We might suggest that the pathogenesis of retinal microvascular changes is related to that of large arterial atherosclerosis.

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