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Fractal Analysis Reveals Reduced Complexity of Retinal Vessels in CADASIL

By Michele Cavallari, Teresa Falco, Marina Frontali, Silvia Romano, Francesca Bagnato and Francesco Orzi

Abstract

The Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) affects mainly small cerebral arteries and leads to disability and dementia. The relationship between clinical expression of the disease and progression of the microvessel pathology is, however, uncertain as we lack tools for imaging brain vessels in vivo. Ophthalmoscopy is regarded as a window into the cerebral microcirculation. In this study we carried out an ophthalmoscopic examination in subjects with CADASIL. Specifically, we performed fractal analysis of digital retinal photographs. Data are expressed as mean fractal dimension (mean-D), a parameter that reflects complexity of the retinal vessel branching. Ten subjects with genetically confirmed diagnosis of CADASIL and 10 sex and age-matched control subjects were enrolled. Fractal analysis of retinal digital images was performed by means of a computer-based program, and the data expressed as mean-D. Brain MRI lesion volume in FLAIR and T1-weighted images was assessed using MIPAV software. Paired t-test was used to disclose differences in mean-D between CADASIL and control groups. Spearman rank analysis was performed to evaluate potential associations between mean-D values and both disease duration and disease severity, the latter expressed as brain MRI lesion volumes, in the subjects with CADASIL. The results showed that mean-D value of patients (1.42±0.05; mean±SD) was lower than control (1.50±0.04; p = 0.002). Mean-D did not correlate with disease duration nor with MRI lesion volumes of the subjects with CADASIL. The findings suggest that fractal analysis is a sensitive tool to assess changes of retinal vessel branching, likely reflecting early brain microvessel alterations, in CADASIL patients

Topics: Research Article
Publisher: Public Library of Science
OAI identifier: oai:pubmedcentral.nih.gov:3083432
Provided by: PubMed Central
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    1. (2002). Atheroslerosis Risk in Communities Study. Cerebral white matter lesions, retinopathy, and incident clinical stroke.
    2. (2010). Cerebrovascular dysfunction and microcirculation rarefaction precede white matter lesions in a mouse genetic model of cerebral ischemic small vessel disease.
    3. (2003). Evolution of T1 black holes in patients with multiple sclerosis imaged monthly for 4 years.
    4. (2010). Fractal analysis of retinal vessels suggests that a distinct vasculopathy causes lacunar stroke.
    5. (2004). Fractal analysis of the vascular tree in the human retina.
    6. (2006). Ophthalmologic findings in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy: a cross-sectional study.
    7. (1995). Quantitative assessment of MRI lesion load in monitoring the evolution of multiple sclerosis.
    8. (2007). Regulation of vascular morphogenesis by Notch signaling.
    9. (2010). Retinal fractals and acute lacunar stroke.
    10. (2009). Retinal microvascular abnormalities and cognitive decline: the ARIC 14-year follow-up study.
    11. (2001). Retinal microvascular abnormalities and incident stroke: the Atherosclerosis Risk in Communities Study.
    12. (2010). Retinal microvascular abnormalities and risk of lacunar stroke: Atherosclerosis Risk in Communities Study.
    13. (2005). Retinal vascular image analysis as a potential screening tool for cerebrovascular disease: a rationale based on homology between cerebral and retinal microvasculatures.
    14. (2008). Virchow-Robin spaces relate to cerebral small vessel disease severity.

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