The Application of Optical Coherence Tomography Angiography in Cerebral Small Vessel Disease, Ischemic Stroke, and Dementia: A Systematic Review
Objective: To investigate the application of optical coherence tomography angiography (OCTA) in cerebral small vessel disease (SVD), ischemic stroke and dementia.Methods: We conducted a systematic search in MEDLINE (from inception) and EMBASE (from 1980) to end 2019 for human studies that measured r...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.01009/full |
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| author | Jun-Fang Zhang Jun-Fang Zhang Stewart Wiseman Maria C. Valdés-Hernández Fergus N. Doubal Baljean Dhillon Baljean Dhillon Yun-Cheng Wu Joanna M. Wardlaw |
| author_facet | Jun-Fang Zhang Jun-Fang Zhang Stewart Wiseman Maria C. Valdés-Hernández Fergus N. Doubal Baljean Dhillon Baljean Dhillon Yun-Cheng Wu Joanna M. Wardlaw |
| author_sort | Jun-Fang Zhang |
| collection | DOAJ |
| description | Objective: To investigate the application of optical coherence tomography angiography (OCTA) in cerebral small vessel disease (SVD), ischemic stroke and dementia.Methods: We conducted a systematic search in MEDLINE (from inception) and EMBASE (from 1980) to end 2019 for human studies that measured retinal parameters in cerebral SVD, ischemic stroke, and dementia using OCTA.Results: Fourteen articles (n = 989) provided relevant data. Ten studies included patients with Alzheimer disease (AD) and mild cognitive impairment (n = 679), two investigated pre-symptomatic AD participants (n = 154), and two investigated monogenic SVD patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (n = 32) and Fabry disease (n = 124). Methods to reduce bias and risk factor adjustment were poorly reported. Substantial methodological variations between studies precluded a formal meta-analysis. Quantitative measurements revealed significant yet inconclusive changes in foveal avascular zone, perfusion density, and vessel density (VD) in AD, presymptomatic AD, and SVD patients. Two (n = 160) of three studies (n = 192) showed association between decreased VD and increased white matter hyperintensities. In three (n = 297) of seven studies (n = 563), better cognitive function was associated with increased VD. One study (n = 52) suggested increased VD was associated with increased ganglion cell–inner plexiform layer thickness in AD yet with no covariate adjustment.Conclusions: Changes in retinal microvasculature identified using OCTA are associated with monogenic SVD and different stages of AD, but data are limited and partly confounded by methodological differences. Larger studies with risk factors adjustment and more consistent OCTA methods are needed to fully exploit this technology.PROSPERO registration number: CRD42020166929. |
| first_indexed | 2024-12-11T06:47:57Z |
| format | Article |
| id | doaj.art-4742b548a500441f875edb310c29d612 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T06:47:57Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-4742b548a500441f875edb310c29d6122022-12-22T01:17:01ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-09-011110.3389/fneur.2020.01009560038The Application of Optical Coherence Tomography Angiography in Cerebral Small Vessel Disease, Ischemic Stroke, and Dementia: A Systematic ReviewJun-Fang Zhang0Jun-Fang Zhang1Stewart Wiseman2Maria C. Valdés-Hernández3Fergus N. Doubal4Baljean Dhillon5Baljean Dhillon6Yun-Cheng Wu7Joanna M. Wardlaw8Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaCentre for Clinical Brain Science, Edinburgh Imaging and UK Dementia Research Institute, University of Edinburgh, Edinburgh, United KingdomCentre for Clinical Brain Science, Edinburgh Imaging and UK Dementia Research Institute, University of Edinburgh, Edinburgh, United KingdomCentre for Clinical Brain Science, Edinburgh Imaging and UK Dementia Research Institute, University of Edinburgh, Edinburgh, United KingdomCentre for Clinical Brain Science, Edinburgh Imaging and UK Dementia Research Institute, University of Edinburgh, Edinburgh, United KingdomCentre for Clinical Brain Science, Edinburgh Imaging and UK Dementia Research Institute, University of Edinburgh, Edinburgh, United KingdomPrincess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, United KingdomDepartment of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaCentre for Clinical Brain Science, Edinburgh Imaging and UK Dementia Research Institute, University of Edinburgh, Edinburgh, United KingdomObjective: To investigate the application of optical coherence tomography angiography (OCTA) in cerebral small vessel disease (SVD), ischemic stroke and dementia.Methods: We conducted a systematic search in MEDLINE (from inception) and EMBASE (from 1980) to end 2019 for human studies that measured retinal parameters in cerebral SVD, ischemic stroke, and dementia using OCTA.Results: Fourteen articles (n = 989) provided relevant data. Ten studies included patients with Alzheimer disease (AD) and mild cognitive impairment (n = 679), two investigated pre-symptomatic AD participants (n = 154), and two investigated monogenic SVD patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (n = 32) and Fabry disease (n = 124). Methods to reduce bias and risk factor adjustment were poorly reported. Substantial methodological variations between studies precluded a formal meta-analysis. Quantitative measurements revealed significant yet inconclusive changes in foveal avascular zone, perfusion density, and vessel density (VD) in AD, presymptomatic AD, and SVD patients. Two (n = 160) of three studies (n = 192) showed association between decreased VD and increased white matter hyperintensities. In three (n = 297) of seven studies (n = 563), better cognitive function was associated with increased VD. One study (n = 52) suggested increased VD was associated with increased ganglion cell–inner plexiform layer thickness in AD yet with no covariate adjustment.Conclusions: Changes in retinal microvasculature identified using OCTA are associated with monogenic SVD and different stages of AD, but data are limited and partly confounded by methodological differences. Larger studies with risk factors adjustment and more consistent OCTA methods are needed to fully exploit this technology.PROSPERO registration number: CRD42020166929.https://www.frontiersin.org/article/10.3389/fneur.2020.01009/fulldementiaAlzheimer's diseaseretinal vasculatureoptical coherence tomography angiographyischemic strokecerebral small vessel disease |
| spellingShingle | Jun-Fang Zhang Jun-Fang Zhang Stewart Wiseman Maria C. Valdés-Hernández Fergus N. Doubal Baljean Dhillon Baljean Dhillon Yun-Cheng Wu Joanna M. Wardlaw The Application of Optical Coherence Tomography Angiography in Cerebral Small Vessel Disease, Ischemic Stroke, and Dementia: A Systematic Review Frontiers in Neurology dementia Alzheimer's disease retinal vasculature optical coherence tomography angiography ischemic stroke cerebral small vessel disease |
| title | The Application of Optical Coherence Tomography Angiography in Cerebral Small Vessel Disease, Ischemic Stroke, and Dementia: A Systematic Review |
| title_full | The Application of Optical Coherence Tomography Angiography in Cerebral Small Vessel Disease, Ischemic Stroke, and Dementia: A Systematic Review |
| title_fullStr | The Application of Optical Coherence Tomography Angiography in Cerebral Small Vessel Disease, Ischemic Stroke, and Dementia: A Systematic Review |
| title_full_unstemmed | The Application of Optical Coherence Tomography Angiography in Cerebral Small Vessel Disease, Ischemic Stroke, and Dementia: A Systematic Review |
| title_short | The Application of Optical Coherence Tomography Angiography in Cerebral Small Vessel Disease, Ischemic Stroke, and Dementia: A Systematic Review |
| title_sort | application of optical coherence tomography angiography in cerebral small vessel disease ischemic stroke and dementia a systematic review |
| topic | dementia Alzheimer's disease retinal vasculature optical coherence tomography angiography ischemic stroke cerebral small vessel disease |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.01009/full |
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