Retinal layers and visual conductivity changes in a case series of microangiopathic ischemic stroke patients
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RESEARCH ARTICLE
Open Access
Retinal layers and visual conductivity changes in a case series of microangiopathic ischemic stroke patients John-Ih Lee1, Lena Gemerzki1, Margit Weise1, Laura Boerker1, Jonas Graf1, Lea Jansen1, Rainer Guthoff2, Orhan Aktas1, Michael Gliem1, Sebastian Jander1, Hans-Peter Hartung1 and Philipp Albrecht1*
Abstract Background: It is unknown whether microangiopathic ischemic strokes outside the visual pathway go along with subclinical changes of the retinal structure or the visual system. The objectives of this prospective noninterventional case series were to investigate if spectral-domain optical coherence tomography (SD-OCT) or multifocal visual evoked potentials (mfVEPs) can detect structural retinal changes or functional impairment of the visual system in patients with microangiopathic ischemic stroke. Methods: We used SD-OCT to cross-sectionally analyze the retinal morphology of 15 patients with microangiopathic ischemic stroke according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification not affecting the visual pathway. We employed semi-automated segmentation of macular volume scans to analyze the thickness of the macular retinal layers and peripapillary ring scans to investigate the retinal morphology in comparison to a control group without stroke. Visual function was assessed by the mfVEP technique in 13 microangiopathic ischemic stroke patients. Results: First peak latency of mfVEPs was significantly delayed in the microangiopathic ischemic stroke group compared to the control patients. Neither the retinal layers nor the mfVEPs’ amplitude differed between the microangiopathic ischemic stroke patients and the control group. Conclusions: In conclusion, microangiopathic ischemic stroke patients presented a delayed first peak latency in mfVEPs as a sign of subclinical functional impairment of the visual pathway. However, our case series suggests no influence on retinal structure resulting from microangiopathic ischemic stroke outside the visual system. Larger and longitudinal studies are needed to confirm these mfVEP findings. Keywords: Optical coherence tomography, Multifocal visual evoked potentials, Ischemic stroke, Microangiopathy
* Correspondence: [email protected] 1 Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and yo
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