ArticleNeurology2025
Midlife Retinal Microvascular Signs and Late-Life Neuroimaging Features of Cerebral Small Vessel Disease in the ARIC Study.
Article in Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between retinal microvascular pathology and lacunar infarction: a systematic review and meta-analysis.International ophthalmology · 2026Pooled it
- Microvascular remodeling and endothelial dysfunction across the post-COVID-19 spectrum: a prospective observational case-control study.BMC medicine · 2026Observational
- Initiating Events of Retinopathy in Spontaneously Hypertensive Rats: Microvascular Rarefaction and Functional Deficits.Hypertension (Dallas, Tex. : 1979) · 2026Article
- Retinal hemodynamic and caliber biomarkers for the assessment of cerebral small vessel disease burden: insights from fundus fluorescein angiography.BMC neurology · 2026Article
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12 authors.
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Abstract
BACKGROUND AND
objectivesCerebral small vessel disease (CSVD) is a leading cause of cognitive and functional deficits. Retinal vasculature abnormalities may be an early indicator of CSVD. The aim of this study was to investigate the associations between retinal signs in midlife and imaging markers of CSVD 18 years later.
methodsThis study included participants from the Atherosclerosis Risk in Communities Study, a prospective community-based cohort, who had retinal imaging at visit 3 (1993-1995) and 3T brain MRI at visit 5 (2011-2013). MRI scans were reviewed centrally and rated for white matter hyperintensities (WMHs), lacunes (present vs absent), cerebral microbleeds (present vs absent), brain volumes (total, lobar, temporoparietal meta region of interest, deep gray subcortical structure), global fractional anisotropy (FA) and mean diffusivity (MD) obtained from diffusion tensor imaging. Retinal imaging was evaluated centrally for 4 retinal signs: (1) central retinal arteriolar equivalent-lowest (worst) quartile vs top 3 quartiles; (2) arteriovenous nicking (present vs absent); (3) focal arteriolar narrowing (present vs absent); (4) retinopathy (mild, moderate, severe vs none). We used multivariable-adjusted Poisson regression with robust SEs for lacunes and cerebral microbleeds and linear regression for other MRI measures. Models were adjusted for age, sex, race-center, education,
resultsAmong 1,809 participants (mean visit 3 age = 59 years, mean visit 5 age = 77 years, 60% female, 27% Black), comparing participants with focal arteriolar narrowing present vs absent, worse white matter integrity (FA: difference = -0.006, 95% CI -0.010 to -0.001; MD: difference = 0.141 × 10 DISCUSSION: Midlife retinal microvascular abnormalities may be a valuable risk indicator of late-life CSVD neuroimaging markers. Retinal fundus photography might be a promising tool for early identification of CSVD.
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