Evidence map›Paper›PMID 35421194›Full record

SynthesisPloS one2022

Retinal biomarkers of Cerebral Small Vessel Disease: A systematic review.

Elena Biffi, Zachary Turple, Jessica Chung, Alessandro Biffi

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Clinical and optical coherence tomography angiography-based risk factors for reduced retinal sensitivity in diabetic macular edema.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Article
  5. Retinal imaging for cerebrovascular risk stratification: evidence, limitations, and practical thresholds for the ophthalmologist.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Article
  12. Article
  13. Brain and retina in Alzheimer's disease: Pathological intersections and estimates from imaging.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Review
  14. The Mechanisms of Inflammatory Factors and the Total Load of Cerebral Small Vessel Disease in Diabetic Retinopathy and Cognitive Impairment.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
    Article
  15. Review
  16. Review
  17. Article
  18. A deep-learning retinal aging biomarker for cognitive decline and incident dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  19. Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study.American heart journal plus : cardiology research and practice · 2025
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Elena BiffiNew England College of Optometry, Boston, MA, United States of America.ORCID 0000-0003-3555-2350
Zachary TurpleNew England College of Optometry, Boston, MA, United States of America.
Jessica ChungNew England College of Optometry, Boston, MA, United States of America.
Alessandro BiffiHenry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States of America.
New England College of Optometry · USMassachusetts General Hospital · US

Funding

SHORT TERM RES TRAINING AT THE NEW ENGLAND COLLEGE OFT35EY007149 · NEI · NEW ENGLAND COLLEGE OF OPTOMETRY · PI Athanasios Panorgias · 1999 to 2026
$1.5M
NEI NIH HHS T35 EY007149
6 · The paper itself

Abstract

introductionCerebral Small Vessel Disease (CSVD), a progressive degenerative disorder of small caliber cerebral vessels, represents a major contributor to stroke and vascular dementia incidence worldwide. We sought to conduct a systematic review of the role of retinal biomarkers in diagnosis and characterization of CSVD.

methodsWe conducted a systematic review of MEDLINE, PubMed, Scopus, the Cochrane Library Database, and Web of Science. We identified studies of sporadic CSVD (including CSVD not otherwise specified, Cerebral Amyloid Angiopathy, and Hypertensive Arteriopathy) and the most common familial CSVD disorders (including CADASIL, Fabry disease, and MELAS). Included studies used one or more of the following tools: visual fields assessment, fundus photography, Optical Coherence Tomography and OCT Angiography, Fluorescein Angiography, Electroretinography, and Visual Evoked Potentials.

resultsWe identified 48 studies of retinal biomarkers in CSVD, including 9147 cases and 12276 controls. Abnormalities in retinal vessel diameter (11 reports, n = 11391 participants), increased retinal vessel tortuosity (11 reports, n = 617 participants), decreased vessel fractal dimension (5 reports, n = 1597 participants) and decreased retinal nerve fiber layer thickness (5 reports, n = 4509 participants) were the biomarkers most frequently associated with CSVD. We identified no reports conducting longitudinal retinal evaluations of CSVD, or systematically evaluating diagnostic performance.

conclusionMultiple retinal biomarkers were associated with CSVD or its validated neuroimaging biomarkers. However, existing evidence is limited by several shortcomings, chiefly small sample size and unstandardized approaches to both biomarkers' capture and CSVD characterization. Additional larger studies will be required to definitively determine whether retinal biomarkers could be successfully incorporated in future research efforts and clinical practice.

Indexed as

Cerebral Small Vessel DiseasesEvoked Potentials, VisualBiomarkersFluorescein AngiographyHumansRetinaBiomarkers

Identifiers

PMID35421194
PMCPMC9009626
OpenAlexW4223903505

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.