Study of Macular Microvascular Changes in Patients with Symptomatic Lacunar Cerebral Infarction Using Viaoptical Coherence Tomography Angiography (OCTA).

Objective: To investigate retinal and choroidal vascular density (VD) changes in the macular region of patients with symptomatic lacunar cerebral infarction (LI) and assess whether these changes can predict symptomatic LI. Methods: This cross-sectional study included 49 symptomatic LI patients (49 eyes) and 51 healthy controls (51 eyes). OCTA was employed to measure retinal VD in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), as well as the ganglion cell complex (GCC) thickness. Enhanced depth imaging optical coherence tomography (EDI-OCT) was utilized to calculate the choroidal vascular index (CVI). Results: Significant differences were observed in macular VD of the SCP and DCP, GCC thickness, and CVI, systolic pressure, diastolic pressure, between the symptomatic LI and control groups (p < 0.05). Binary logistic regression analysis indicated that lower VD in the SCP and DCP, along with reduced GCC thickness, elevated diastolic blood pressure, were significantly associated with symptomatic LI (OR < 1, p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) was higher for SCP total vessel density and GCC thickness, while the whole VD of SCP+GCC thickness had the highest area under the curve (AUC =0.880, sensitivity =87.80% and specificity =74.50%). Conclusion: In patients with symptomatic LI, reductions in VD within the SCP and DCP, along with decreased GCC thickness and CVI, were observed. These diminished vascular densities in the SCP and reduced GCC thickness may serve as predictive markers for symptomatic LI.