Role of Retinal Microvascular Changes in Predicting Ischemic Stroke Outcomes

To evaluate the relationship between retinal microvascular changes detected by OCTA and clinical outcomes assessed by the National Institutes of Health Stroke Scale (NIHSS) and the Modified Barthel Index (mBI) in patients with acute ischemic stroke, a prospective observational case–control study was conducted on ۸۰ participants (۴۰ ischemic stroke patients and ۴۰ controls) at Al-Zahraa University Hospital from June ۲۰۲۳ to June ۲۰۲۴. All patients underwent neurological evaluation using NIHSS and functional assessment using mBI within ۴۸ hours and after three months. OCTA was used to measure ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) thickness, and vessel densities of the superficial (SCP), deep (DCP), and radial peripapillary capillary (RPC) plexuses. Correlations between OCTA parameters and clinical scores were analyzed, and diagnostic performance was assessed by ROC analysis. Stroke patients showed significant reductions in GCC and RNFL thickness and decreased vessel densities in SCP, DCP, and RPC layers compared with controls (p < ۰.۰۰۱). Higher NIHSS scores correlated negatively with GCC and RNFL thickness and SCP/DCP vessel densities, whereas mBI improvement correlated positively with SCP and RPC densities. Inferior RNFL and parafoveal SCP exhibited the highest diagnostic accuracy (AUC > ۰.۸۵). Retinal microvascular and neuronal alterations detected by OCTA mirror cerebral ischemic injury and correlate with stroke severity and functional recovery. OCTA may serve as a promising, non-invasive biomarker for assessing and predicting outcomes in ischemic stroke.

کلیدواژه ها:

Stroke ، Optical Coherence Tomography Angiography ، NIHSS ، Modified Barthel Index ، Retinal Microvasculature