{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:08:38Z","timestamp":1775840918269,"version":"3.50.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009331","name":"Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:p><jats:bold>Background<\/jats:bold>: This study aims to evaluate ocular changes in patients with ischemic stroke using multimodal imaging and explore the predictive value of ocular abnormalities for ischemic stroke.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: A total of 203 patients (ischemic stroke group, 62; control group, 141) were enrolled in this study. Basic data from patients, including age; gender; height; weight; history of hypertension, hyperlipidemia, diabetes, alcohol use, and coronary heart disease; and smoking status, were collected. Consequently, Doppler color ultrasound, color fundus photography, and optical coherence tomography (OCT) examinations were conducted. Differences in traditional risk factors and ocular parameters between the two groups were compared, and binary logistic regression was used for multivariate analysis.<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>: The central retinal artery equivalent (CRAE) in the ischemic stroke group was 150.72 \u00b1 20.15 \u03bcm and that in the control group was 159.68 \u00b1 20.05 \u03bcm. The difference was statistically significant (<jats:italic>P<\/jats:italic> = 0.004). Moreover, the subfoveal choroidal thickness (SFChT) in the ischemic stroke group was 199.90 \u00b1 69.27 \u03bcm and that in the control group was 227.40 \u00b1 62.20 \u03bcm. The difference was statistically significant (<jats:italic>P<\/jats:italic> = 0.006). Logistic regression results showed that smoking [odds ratio (OR) = 2.823; 95% confidence interval (95% CI) = 1.477\u20135.395], CRAE (OR = 0.980; 95% CI = 0.965\u20130.996), and SFChT (OR = 0.994; 95% CI = 0.989\u20130.999) are associated with increased risk of ischemic stroke when ocular parameters were combined with traditional risk factors. The area under the receiver operating characteristic (ROC) curve was 0.726, which shows good diagnostic accuracy.<\/jats:p><jats:p><jats:bold>Conclusion<\/jats:bold>: SFChT may be a diagnostic marker for early detection and monitoring of ischemic stroke. Combined with traditional risks, retinal artery diameter, and choroidal thickness, the prediction model can improve ischemic stroke prediction.<\/jats:p>","DOI":"10.3389\/fnagi.2021.615813","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T06:21:31Z","timestamp":1612246891000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Multimodal Retinal Imaging for Detection of Ischemic Stroke"],"prefix":"10.3389","volume":"13","author":[{"given":"Lu","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiufen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanling","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1111\/aos.12962","article-title":"Ocular blood flow in glaucoma\u2014the leuven eye study","volume":"94","author":"Abeg\u00e3o Pinto","year":"2016","journal-title":"Acta Ophthalmol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1161\/01.str.24.1.35","article-title":"Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. trial of org 10172 in acute stroke treatment","volume":"24","author":"Adams","year":"1993","journal-title":"Stroke"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.3109\/02713683.2014.898310","article-title":"Subfoveal choroidal thickness in patients with chronic heart failure analyzed by spectral-domain optical coherence tomography","volume":"39","author":"Altinkaynak","year":"2014","journal-title":"Curr. Eye Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"4756313","DOI":"10.1155\/2018\/4756313","article-title":"Acute effect of hypervolemic hemodilution on retrobulbar hemodynamics in anterior ischemic optic neuropathy","volume":"2018","author":"Bienert","year":"2018","journal-title":"Biomed. Res. Int."},{"key":"B5","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1161\/CIRCRESAHA.116.308398","article-title":"Stroke risk factors, genetics and prevention","volume":"120","author":"Boehme","year":"2017","journal-title":"Circ. Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1111\/j.1755-5949.2011.00292.x","article-title":"Classifying ischemic stroke, from TOAST to CISS","volume":"18","author":"Chen","year":"2012","journal-title":"CNS Neurosci. Ther."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2402","DOI":"10.1161\/STROKEAHA.113.001738","article-title":"Retinal microvascular changes and risk of stroke: the singapore malay eye study","volume":"44","author":"Cheung","year":"2013","journal-title":"Stroke"},{"key":"B28","doi-asserted-by":"publisher","first-page":"246","DOI":"10.3760\/cma.j.issn.1006-7876.2015.04.002","article-title":"Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2014","volume":"48","year":"2015","journal-title":"Chin. J. Neurol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.survophthal.2009.06.010","article-title":"Color doppler imaging of retinal diseases","volume":"55","author":"Dimitrova","year":"2010","journal-title":"Surv. Ophthalmol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1136\/jnnp.2008.153460","article-title":"Retinal microvascular abnormalities and stroke: a systematic review","volume":"80","author":"Doubal","year":"2009","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1960","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.02.041","article-title":"Retinal microvascular abnormalities as surrogate markers of cerebrovascular ischemic disease: a meta-analysis","volume":"27","author":"Dumitrascu","year":"2018","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.4103\/0366-6999.204935","article-title":"Study of enhanced depth imaging optical coherence tomography in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy","volume":"130","author":"Fang","year":"2017","journal-title":"Chin. Med. J."},{"key":"B12","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3389\/fneur.2011.00006","article-title":"Chinese ischemic stroke subclassification","volume":"2","author":"Gao","year":"2011","journal-title":"Front. Neurol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2269","DOI":"10.1016\/s0161-6420(99)90525-0","article-title":"Methods for evaluation of retinal microvascular abnormalities associated with hypertension\/sclerosis in the atherosclerosis risk in communities study","volume":"106","author":"Hubbard","year":"1999","journal-title":"Ophthalmology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2862","DOI":"10.1161\/STROKEAHA.116.014998","article-title":"Association of retinopathy and retinal microvascular abnormalities with stroke and cerebrovascular disease","volume":"47","author":"Hughes","year":"2016","journal-title":"Stroke"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1212\/01.wnl.0000210533.24338.ea","article-title":"Retinal vessel diameters and risk of stroke: the rotterdam study","volume":"66","author":"Ikram","year":"2006","journal-title":"Neurology"},{"key":"B16","doi-asserted-by":"publisher","first-page":"397","DOI":"10.2298\/VSP140814087C","article-title":"Color doppler imaging features in patients presenting central retinal artery occlusion with and without giant cell arteritis","volume":"73","author":"Jianu","year":"2016","journal-title":"Vojnosanit. Pregl."},{"key":"B17","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1002\/jcu.22812","article-title":"Abnormal retrobulbar blood flow variables in central serous chorioretinopathy","volume":"48","author":"Kilic","year":"2020","journal-title":"J. Clin. Ultrasound"},{"key":"B18","doi-asserted-by":"publisher","first-page":"620372","DOI":"10.1155\/2015\/620372","article-title":"Choroidal thickness in eyes with unilateral ocular ischemic syndrome","volume":"2015","author":"Kim","year":"2015","journal-title":"J. Ophthalmol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"4019538","DOI":"10.1155\/2018\/4019538","article-title":"A review on the extraction of quantitative retinal microvascular image feature","volume":"2018","author":"Kipli","year":"2018","journal-title":"Comput. Math. Methods Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1001\/archopht.117.8.1063","article-title":"Retinal emboli and stroke: the beaver dam eye study","volume":"117","author":"Klein","year":"1999","journal-title":"Arch. Ophthalmol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1076\/ceyr.27.3.143.16049","article-title":"Revised formulas for summarizing retinal vessel diameters","volume":"27","author":"Knudtson","year":"2003","journal-title":"Curr. Eye Res."},{"key":"B22","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1007\/s10792-018-0846-x","article-title":"Retrobulbar and intraocular blood flow in anterior ischaemic optic neuropathy are linked to the functional impairment","volume":"39","author":"Kuerten","year":"2019","journal-title":"Int. Ophthalmol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1038\/nrneurol.2012.227","article-title":"The retina as a window to the brain-from eye research to CNS disorders","volume":"9","author":"London","year":"2013","journal-title":"Nat. Rev. Neurol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1093\/aje\/kwp306","article-title":"Prediction of incident stroke events based on retinal vessel caliber: a systematic review and individual-participant meta-analysis","volume":"170","author":"McGeechan","year":"2009","journal-title":"Am. J. Epidemiol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"6320","DOI":"10.1038\/s41598-019-42534-x","article-title":"Retinal microvasculature and cerebral small vessel disease in the lothian birth cohort 1936 and mild stroke study","volume":"9","author":"McGrory","year":"2019","journal-title":"Sci. Rep."},{"key":"B26","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1111\/ene.13409","article-title":"Ischaemic stroke","volume":"25","author":"Meschia","year":"2018","journal-title":"Eur. J. Neurol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1212\/01.wnl.0000179177.15900.ca","article-title":"Retinal microvascular signs and risk of stroke and stroke mortality","volume":"65","author":"Mitchell","year":"2005","journal-title":"Neurology"},{"key":"B29","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.oftal.2018.01.004","article-title":"Update on visual function and choroidal-retinal thickness alterations in Parkinson\u2019s disease","volume":"93","author":"Obis","year":"2018","journal-title":"Arch. Soc. Esp. Oftalmol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"28","DOI":"10.15557\/JoU.2014.0003","article-title":"Color doppler imaging of the retrobulbar vessels in diabetic retinopathy","volume":"14","author":"Pauk-Doma\u0144ska","year":"2014","journal-title":"J. Ultrason."},{"key":"B31","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1097\/WNO.0000000000000888","article-title":"Retinal vascular signs and cerebrovascular diseases","volume":"40","author":"Rim","year":"2020","journal-title":"J. Neuroophthalmol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1161\/CIRCULATIONAHA.116.023425","article-title":"Retinal vessel calibers in predicting long-term cardiovascular outcomes: the atherosclerosis risk in communities study","volume":"134","author":"Seidelmann","year":"2016","journal-title":"Circulation"},{"key":"B34","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1046\/j.1442-9071.2002.00520.x","article-title":"Reliability of computer-assisted retinal vessel measurementin a population","volume":"30","author":"Sherry","year":"2002","journal-title":"Clin. Exp. Ophthalmol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/j.survophthal.2019.04.007","article-title":"Choroidal and retinal thickness in systemic autoimmune and inflammatory diseases: a review","volume":"64","author":"Steiner","year":"2019","journal-title":"Surv. Ophthalmol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1016\/j.survophthal.2016.02.007","article-title":"State of science: choroidal thickness and systemic health","volume":"61","author":"Tan","year":"2016","journal-title":"Surv. Ophthalmol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"285","DOI":"10.18502\/jovr.v14i3.4784","article-title":"Choroidal thickness and hemoglobin a1c levels in patients with type 2 diabetes mellitus","volume":"14","author":"Torabi","year":"2019","journal-title":"J. Ophthalmic Vis. Res."},{"key":"B38","doi-asserted-by":"publisher","first-page":"2388","DOI":"10.1001\/archinte.166.21.2388","article-title":"Quantitative retinal venular caliber and risk of cardiovascular disease in older persons: the cardiovascular health study","volume":"166","author":"Wong","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1134","DOI":"10.1016\/S0140-6736(01)06253-5","article-title":"Retinal microvascular abnormalities and incident stroke: the atherosclerosis risk in communities study","volume":"358","author":"Wong","year":"2001","journal-title":"Lancet"},{"key":"B40","doi-asserted-by":"publisher","first-page":"8079127","DOI":"10.1155\/2019\/8079127","article-title":"Effects of cigarette smoking on retinal and choroidal thickness: a systematic review and meta-analysis","volume":"2019","author":"Yang","year":"2019","journal-title":"J. Ophthalmol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1161\/STROKEAHA.110.580837","article-title":"Retinal microvascular abnormalities and risk of lacunar stroke: atherosclerosis risk in communities study","volume":"41","author":"Yatsuya","year":"2010","journal-title":"Stroke"},{"key":"B42","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1097\/IIO.0000000000000261","article-title":"Retinal imaging for neurological diseases: \u201ca window into the brain\u201d","volume":"59","author":"Zafar","year":"2019","journal-title":"Int. Ophthalmol. Clin."},{"key":"B43","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s13760-014-0301-3","article-title":"Choroidal thickness changes in patients with migraine","volume":"115","author":"Zengin","year":"2015","journal-title":"Acta. Neurol. Belg."},{"key":"B44","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1136\/svn-2018-000226","article-title":"Ischaemic stroke etiological classification system: the agreement analysis of CISS, SPARKLE and TOAST","volume":"4","author":"Zhang","year":"2019","journal-title":"Stroke Vasc. Neurol."}],"container-title":["Frontiers in Aging Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2021.615813\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T06:21:34Z","timestamp":1612246894000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2021.615813\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,2]]},"references-count":43,"alternative-id":["10.3389\/fnagi.2021.615813"],"URL":"https:\/\/doi.org\/10.3389\/fnagi.2021.615813","relation":{},"ISSN":["1663-4365"],"issn-type":[{"value":"1663-4365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,2]]},"article-number":"615813"}}