Retinal Vascular Hemodynamic Changes in Patients with Ischemic Stroke Investigated by Fundus Laser Speckle Contrast Imaging

Purpose: To investigate the retinal hemodynamic changes in patients with ischemic stroke using fundus laser speckle contrast imaging (LSCI) and evaluate their microcirculatory impairment. Methods: This cross-sectional study was conducted in the Department of Neurology at Xuanwu Hospital, Capital Medical University. An integrated retinal imaging instrument was employed to collect images of retinal vascular LSCI in patients with ischemic stroke, and the pulse wave waveform parameters were compared with healthy controls. Results: A total of 119 patients with 233 eyes in ischemic stroke group and 67 patients with 113 eyes in the healthy control group were enrolled. Among the fundus vascular waveform parameters, the Flow Acceleration Index (FAI) and Resistivity Index (RI) in ischemic stroke patients were higher than those in the healthy control group ( p = 0.028 and 0.015, respectively), while the Blowout Time (BOT), Blowout Score (BOS) and Rising Rate (RR) were lower than those in the control group ( p values of 0.021, 0.014, and 0.010, respectively). After correcting for confounders by multifactor logistic regression, BOT, RR, and RI ( p values of 0.008, 0.020, and 0.049, respectively) remained statistically significant. Furthermore, most hemodynamic parameters in healthy controls showed significant correlations with age [FAI ( r = 0.200, p = 0.041), BOT ( r = -0.221, p = 0.020), BOS ( r = -0.232, p = 0.014), RI ( r = 0.218, p = 0.020)], whereas few indicators in ischemic stroke patients exhibited a correlation with age. Conclusion: Retinal vascular elasticity in ischemic stroke patients is compromised, and the process of changing microcirculation hemodynamics with aging is disrupted. Retinal hemodynamic parameters may serve as potential indicators for evaluating microcirculatory injury in ischemic stroke patients.