Meishuang Li,1– 4,* Huiyu Xi,1,3,4,* Rongrong Guan,5,* Yalu Liu,1,3,4 Lina Guan,1,3,4 Dandan Zong,1,4,6 Nuan Wang,1,4 Haiyang Liu1,3,4 

1Department of Ophthalmology, Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of China; 2Department of Ophthalmology, Lianyungang Eye Hospital, Lianyungang, People’s Republic of China; 3Department of Ophthalmology, Eye Disease Prevention and Treatment Institute, Xuzhou, People’s Republic of China; 4Department of Ophthalmology, Xuzhou First People’s Hospital, Xuzhou, People’s Republic of China; 5Department of Ophthalmology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, People’s Republic of China; 6Department of Ophthalmology, Xuzhou Jiawang District People’s Hospital, Xuzhou, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Haiyang Liu, Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People’s Hospital, Eye Disease Prevention and Treatment Institute of Xuzhou, No. 269 Daxue Road, Tongshan District, Xuzhou, 221116, People’s Republic of China, Tel +8613685167216, Email liuhaiyang86@126.com Nuan Wang, Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People’s Hospital, No. 269 Daxue Road, Tongshan District, Xuzhou, 221116, People’s Republic of China, Email 1279814072@qq.com

Objective: To investigate retinal and choroidal vascular density (VD) changes in the macular region of patients with symptomatic lacunar cerebral infarction (LI) and assess whether these changes can predict symptomatic LI.
Methods: This cross-sectional study included 49 symptomatic LI patients (49 eyes) and 51 healthy controls (51 eyes). OCTA was employed to measure retinal VD in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), as well as the ganglion cell complex (GCC) thickness. Enhanced depth imaging optical coherence tomography (EDI-OCT) was utilized to calculate the choroidal vascular index (CVI).
Results: Significant differences were observed in macular VD of the SCP and DCP, GCC thickness, and CVI, systolic pressure, diastolic pressure, between the symptomatic LI and control groups (p < 0.05). Binary logistic regression analysis indicated that lower VD in the SCP and DCP, along with reduced GCC thickness, elevated diastolic blood pressure, were significantly associated with symptomatic LI (OR < 1, p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) was higher for SCP total vessel density and GCC thickness, while the whole VD of SCP+GCC thickness had the highest area under the curve (AUC =0.880, sensitivity =87.80% and specificity =74.50%).
Conclusion: In patients with symptomatic LI, reductions in VD within the SCP and DCP, along with decreased GCC thickness and CVI, were observed. These diminished vascular densities in the SCP and reduced GCC thickness may serve as predictive markers for symptomatic LI.

Keywords: symptomatic lacunar cerebral infarction, vascular density, thickness of ganglion cell complex, optical coherence tomography vascular imaging technology