Retinal vessel multifractals predict pial collateral status in patients with acute ischemic stroke.
<h4>Objectives</h4>Pial collateral blood flow is a major determinant of the outcomes of acute ischemic stroke. This study was undertaken to determine whether retinal vessel metrics can predict the pial collateral status and stroke outcomes in patients.<h4>Methods</h4>Thirty-f...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0267837 |
| _version_ | 1818473312734412800 |
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| author | Adnan Khan Patrick De Boever Nele Gerrits Naveed Akhtar Maher Saqqur Georgios Ponirakis Hoda Gad Ioannis N Petropoulos Ashfaq Shuaib James E Faber Saadat Kamran Rayaz A Malik |
| author_facet | Adnan Khan Patrick De Boever Nele Gerrits Naveed Akhtar Maher Saqqur Georgios Ponirakis Hoda Gad Ioannis N Petropoulos Ashfaq Shuaib James E Faber Saadat Kamran Rayaz A Malik |
| author_sort | Adnan Khan |
| collection | DOAJ |
| description | <h4>Objectives</h4>Pial collateral blood flow is a major determinant of the outcomes of acute ischemic stroke. This study was undertaken to determine whether retinal vessel metrics can predict the pial collateral status and stroke outcomes in patients.<h4>Methods</h4>Thirty-five patients with acute stroke secondary to middle cerebral artery (MCA) occlusion underwent grading of their pial collateral status from computed tomography angiography and retinal vessel analysis from retinal fundus images.<h4>Results</h4>The NIHSS (14.7 ± 5.5 vs 10.1 ± 5.8, p = 0.026) and mRS (2.9 ± 1.6 vs 1.9 ± 1.3, p = 0.048) scores were higher at admission in patients with poor compared to good pial collaterals. Retinal vessel multifractals: D0 (1.673±0.028vs1.652±0.025, p = 0.028), D1 (1.609±0.027vs1.590±0.025, p = 0.044) and f(α)max (1.674±0.027vs1.652±0.024, p = 0.019) were higher in patients with poor compared to good pial collaterals. Furthermore, support vector machine learning achieved a fair sensitivity (0.743) and specificity (0.707) for differentiating patients with poor from good pial collaterals. Age (p = 0.702), BMI (p = 0.422), total cholesterol (p = 0.842), triglycerides (p = 0.673), LDL (p = 0.952), HDL (p = 0.366), systolic blood pressure (p = 0.727), HbA1c (p = 0.261) and standard retinal metrics including CRAE (p = 0.084), CRVE (p = 0.946), AVR (p = 0.148), tortuosity index (p = 0.790), monofractal Df (p = 0.576), lacunarity (p = 0.531), curve asymmetry (p = 0.679) and singularity length (p = 0.937) did not differ between patients with poor compared to good pial collaterals.<h4>Conclusions</h4>This is the first translational study to show increased retinal vessel multifractal dimensions in patients with acute ischemic stroke and poor pial collaterals. A retinal vessel classifier was developed to differentiate between patients with poor and good pial collaterals and may allow rapid non-invasive identification of patients with poor pial collaterals. |
| first_indexed | 2024-04-14T04:22:36Z |
| format | Article |
| id | doaj.art-12d7016e314349ce95e386677eb35cfc |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-14T04:22:36Z |
| publishDate | 2022-01-01 |
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| spelling | doaj.art-12d7016e314349ce95e386677eb35cfc2022-12-22T02:12:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01175e026783710.1371/journal.pone.0267837Retinal vessel multifractals predict pial collateral status in patients with acute ischemic stroke.Adnan KhanPatrick De BoeverNele GerritsNaveed AkhtarMaher SaqqurGeorgios PonirakisHoda GadIoannis N PetropoulosAshfaq ShuaibJames E FaberSaadat KamranRayaz A Malik<h4>Objectives</h4>Pial collateral blood flow is a major determinant of the outcomes of acute ischemic stroke. This study was undertaken to determine whether retinal vessel metrics can predict the pial collateral status and stroke outcomes in patients.<h4>Methods</h4>Thirty-five patients with acute stroke secondary to middle cerebral artery (MCA) occlusion underwent grading of their pial collateral status from computed tomography angiography and retinal vessel analysis from retinal fundus images.<h4>Results</h4>The NIHSS (14.7 ± 5.5 vs 10.1 ± 5.8, p = 0.026) and mRS (2.9 ± 1.6 vs 1.9 ± 1.3, p = 0.048) scores were higher at admission in patients with poor compared to good pial collaterals. Retinal vessel multifractals: D0 (1.673±0.028vs1.652±0.025, p = 0.028), D1 (1.609±0.027vs1.590±0.025, p = 0.044) and f(α)max (1.674±0.027vs1.652±0.024, p = 0.019) were higher in patients with poor compared to good pial collaterals. Furthermore, support vector machine learning achieved a fair sensitivity (0.743) and specificity (0.707) for differentiating patients with poor from good pial collaterals. Age (p = 0.702), BMI (p = 0.422), total cholesterol (p = 0.842), triglycerides (p = 0.673), LDL (p = 0.952), HDL (p = 0.366), systolic blood pressure (p = 0.727), HbA1c (p = 0.261) and standard retinal metrics including CRAE (p = 0.084), CRVE (p = 0.946), AVR (p = 0.148), tortuosity index (p = 0.790), monofractal Df (p = 0.576), lacunarity (p = 0.531), curve asymmetry (p = 0.679) and singularity length (p = 0.937) did not differ between patients with poor compared to good pial collaterals.<h4>Conclusions</h4>This is the first translational study to show increased retinal vessel multifractal dimensions in patients with acute ischemic stroke and poor pial collaterals. A retinal vessel classifier was developed to differentiate between patients with poor and good pial collaterals and may allow rapid non-invasive identification of patients with poor pial collaterals.https://doi.org/10.1371/journal.pone.0267837 |
| spellingShingle | Adnan Khan Patrick De Boever Nele Gerrits Naveed Akhtar Maher Saqqur Georgios Ponirakis Hoda Gad Ioannis N Petropoulos Ashfaq Shuaib James E Faber Saadat Kamran Rayaz A Malik Retinal vessel multifractals predict pial collateral status in patients with acute ischemic stroke. PLoS ONE |
| title | Retinal vessel multifractals predict pial collateral status in patients with acute ischemic stroke. |
| title_full | Retinal vessel multifractals predict pial collateral status in patients with acute ischemic stroke. |
| title_fullStr | Retinal vessel multifractals predict pial collateral status in patients with acute ischemic stroke. |
| title_full_unstemmed | Retinal vessel multifractals predict pial collateral status in patients with acute ischemic stroke. |
| title_short | Retinal vessel multifractals predict pial collateral status in patients with acute ischemic stroke. |
| title_sort | retinal vessel multifractals predict pial collateral status in patients with acute ischemic stroke |
| url | https://doi.org/10.1371/journal.pone.0267837 |
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