Role of Retinal Microvascular Changes in Predicting Ischemic Stroke Outcomes
نویسندگان
1 Department of Neurology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
2 Department of Neurology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
3 Department of Neurology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
4 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
5 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
6 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
7 Department of Geriatric and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
8 Department of Neurology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
9 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
10 Department of Neurology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
11 Department of Neurology, Faculty of Medicine, Mansoura University, Egypt
12 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
13 Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
14 Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
15 Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
doi
10.48309/jmcs.2026.566072.2907چکیده
To evaluate the relationship between retinal microvascular changes detected by OCTA and clinical outcomes assessed by the National Institutes of Health Stroke Scale (NIHSS) and the Modified Barthel Index (mBI) in patients with acute ischemic stroke, a prospective observational case–control study was conducted on 80 participants (40 ischemic stroke patients and 40 controls) at Al-Zahraa University Hospital from June 2023 to June 2024. All patients underwent neurological evaluation using NIHSS and functional assessment using mBI within 48 hours and after three months. OCTA was used to measure ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) thickness, and vessel densities of the superficial (SCP), deep (DCP), and radial peripapillary capillary (RPC) plexuses. Correlations between OCTA parameters and clinical scores were analyzed, and diagnostic performance was assessed by ROC analysis. Stroke patients showed significant reductions in GCC and RNFL thickness and decreased vessel densities in SCP, DCP, and RPC layers compared with controls (p < 0.001). Higher NIHSS scores correlated negatively with GCC and RNFL thickness and SCP/DCP vessel densities, whereas mBI improvement correlated positively with SCP and RPC densities. Inferior RNFL and parafoveal SCP exhibited the highest diagnostic accuracy (AUC > 0.85). Retinal microvascular and neuronal alterations detected by OCTA mirror cerebral ischemic injury and correlate with stroke severity and functional recovery. OCTA may serve as a promising, non-invasive biomarker for assessing and predicting outcomes in ischemic stroke.
