Multimodal retinal vessel analysis in CADASIL patients.
OBJECTIVE
To further elucidate retinal findings and retinal vessel changes in Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) patients by means of high resolution retinal imaging.


METHODS
28 eyes of fourteen CADASIL patients and an equal number of control subjects underwent confocal scanning laser ophthalmoscopy (cSLO), spectral-domain optical coherence tomography (SD-OCT), retinal nerve fibre layer (RNFL) measurements, fluorescein and indocyanine angiography. Three vessel measurement techniques were applied: RNFL thickness, a semiautomatic software tool based on cSLO images and manual vessel outlining based on SD-OCT.


RESULTS
Mean age of patients was 56.2 ± 11.6 years. Arteriovenous nicking was present in 22 (78.6%) eyes and venous dilation in 24 (85.7%) eyes. Retinal volume and choroidal volume were 8.77 ± 0.46 mm(3) and 8.83 ± 2.24 mm(3). RNFL measurements showed a global increase of 105.2 µm (


METHODS
98.4 µm; p = 0.015). Based on semi-automatic cSLO measurements, maximum diameters of arteries and veins were 102.5 µm (106.0 µm; p = 0.21) and 128.6 µm (124.4 µm; p = 0.27) respectively. Manual SD-OCT measurements revealed significantly increased mean arterial 138.7 µm (125.4 µm; p<0.001) and venous 160.0 µm (146.9; p = 0.003) outer diameters as well as mean arterial 27.4 µm (19.2 µm; p<0.001) and venous 18.3 µm (15.7 µm; p<0.001) wall thicknesses in CADASIL patients.


CONCLUSIONS
The findings reflect current knowledge on pathophysiologic changes in vessel morphology in CADASIL patients. SD-OCT may serve as a complementary tool to diagnose and follow-up patients suffering from cerebral small-vessel diseases.
Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany.
Florian
F
Alten
Department of Neurology, University of Muenster Medical Center, Muenster, Germany.
Jeremias
J
Motte
Department of Neurology, University of Muenster Medical Center, Muenster, Germany.
Carina
C
Ewering
Department of Medical Informatics and Biomathematics, University of Muenster, Muenster, Germany.
Nani
N
Osada
Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany.
Christoph R
CR
Clemens
Department of Neurology, Charite University Medicine Berlin, Berlin, German.
Ella M
EM
Kadas
Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany.
Nicole
N
Eter
Department of Neurology, Charite University Medicine Berlin, Berlin, German; NeuroCure Clinical Research Center, Berlin, Germany.
Friedemann
F
Paul
Department of Neurology, University of Muenster Medical Center, Muenster, Germany.
Martin
M
Marziniak
D000368:Aged; D000792:Angiography; D046589:CADASIL / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D012171:Retinal Vessels / Q000473:pathology*; D041623:Tomography, Optical Coherence