In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 5 ( 2022-5-5), p. e0267837-
Abstract:
Pial collateral blood flow is a major determinant of the outcomes of acute ischemic stroke. This study was undertaken to determine whether retinal vessel metrics can predict the pial collateral status and stroke outcomes in patients. Methods Thirty-five patients with acute stroke secondary to middle cerebral artery (MCA) occlusion underwent grading of their pial collateral status from computed tomography angiography and retinal vessel analysis from retinal fundus images. Results The NIHSS (14.7 ± 5.5 vs 10.1 ± 5.8, p = 0.026) and mRS (2.9 ± 1.6 vs 1.9 ± 1.3, p = 0.048) scores were higher at admission in patients with poor compared to good pial collaterals. Retinal vessel multifractals: D 0 (1.673±0.028vs1.652±0.025, p = 0.028), D 1 (1.609±0.027vs1.590±0.025, p = 0.044) and f(α)max (1.674±0.027vs1.652±0.024, p = 0.019) were higher in patients with poor compared to good pial collaterals. Furthermore, support vector machine learning achieved a fair sensitivity (0.743) and specificity (0.707) for differentiating patients with poor from good pial collaterals. Age ( p = 0.702), BMI ( p = 0.422), total cholesterol ( p = 0.842), triglycerides ( p = 0.673), LDL ( p = 0.952), HDL ( p = 0.366), systolic blood pressure ( p = 0.727), HbA 1c ( p = 0.261) and standard retinal metrics including CRAE ( p = 0.084), CRVE ( p = 0.946), AVR ( p = 0.148), tortuosity index ( p = 0.790), monofractal D f ( p = 0.576), lacunarity ( p = 0.531), curve asymmetry ( p = 0.679) and singularity length ( p = 0.937) did not differ between patients with poor compared to good pial collaterals. Conclusions This is the first translational study to show increased retinal vessel multifractal dimensions in patients with acute ischemic stroke and poor pial collaterals. A retinal vessel classifier was developed to differentiate between patients with poor and good pial collaterals and may allow rapid non-invasive identification of patients with poor pial collaterals.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0267837
DOI:
10.1371/journal.pone.0267837.g001
DOI:
10.1371/journal.pone.0267837.g002
DOI:
10.1371/journal.pone.0267837.g003
DOI:
10.1371/journal.pone.0267837.t001
DOI:
10.1371/journal.pone.0267837.t002
DOI:
10.1371/journal.pone.0267837.r001
DOI:
10.1371/journal.pone.0267837.r002
DOI:
10.1371/journal.pone.0267837.r003
DOI:
10.1371/journal.pone.0267837.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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