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Background <p>Frontotemporal dementia (FTD) is a neurodegenerative disorder with a suspected vascular component. However, the relationship between retinal and cerebral microvascular alterations in FTD remains underexplored. This study investigates retinal microvasculature and its association with cerebral small vessel disease (SVD) markers in FTD using optical coherence tomography angiography (OCTA) and MRI.</p> Methods <p>In this cross-sectional study, 33 patients with clinically diagnosed FTD and 43 cognitively unimpaired controls (CU) underwent multimodal imaging, including OCTA and 3.0T MRI. Retinal vessel density and choriocapillaris perfusion were quantified using OCTA, while cerebral SVD markers, such as white matter hyperintensities (WMH) and perivascular spaces (PVS), were evaluated through both visual and automated methods. The correlation between retinal and cerebral microvascular changes was assessed using statistical models adjusting for potential confounders.</p> Results <p>FTD patients demonstrated significantly reduced retinal and choriocapillaris perfusion compared to CU (all <i>p</i> &lt; 0.001). Notably, decreased superficial vascular complex (SVC) density correlated with higher WMH and PVS volumes. Choriocapillaris perfusion showed the highest diagnostic accuracy (AUC = 0.993) for distinguishing FTD from CU. Furthermore, OCTA metrics, particularly reduced SVC density, were significantly associated with increased SVD burden, indicating a link between retinal microvascular changes and cerebral small vessel pathology in FTD.</p> Discussion <p>Our findings support a retina–brain microvascular axis in FTD, where retinal microvascular alterations may reflect cerebral SVD burden. These results highlight the potential of OCTA as a noninvasive biomarker for monitoring vascular contributions to frontotemporal neurodegeneration. The study provides a framework that using OCTA-derived metrics may help improve early diagnosis, disease stratification, and monitoring of vascular involvement in FTD.</p>

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Retinal microvascular alterations reflect cerebral small vessel disease burden in frontotemporal dementia: a multimodal OCTA–MRI Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月23日

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  • Yufei Chen,
  • William Robert Kwapong,
  • Xu Chen,
  • Yuan Gao,
  • Min Chu,
  • Xuxiang Zhang,
  • Liyong Wu

摘要

Background

Frontotemporal dementia (FTD) is a neurodegenerative disorder with a suspected vascular component. However, the relationship between retinal and cerebral microvascular alterations in FTD remains underexplored. This study investigates retinal microvasculature and its association with cerebral small vessel disease (SVD) markers in FTD using optical coherence tomography angiography (OCTA) and MRI.

Methods

In this cross-sectional study, 33 patients with clinically diagnosed FTD and 43 cognitively unimpaired controls (CU) underwent multimodal imaging, including OCTA and 3.0T MRI. Retinal vessel density and choriocapillaris perfusion were quantified using OCTA, while cerebral SVD markers, such as white matter hyperintensities (WMH) and perivascular spaces (PVS), were evaluated through both visual and automated methods. The correlation between retinal and cerebral microvascular changes was assessed using statistical models adjusting for potential confounders.

Results

FTD patients demonstrated significantly reduced retinal and choriocapillaris perfusion compared to CU (all p < 0.001). Notably, decreased superficial vascular complex (SVC) density correlated with higher WMH and PVS volumes. Choriocapillaris perfusion showed the highest diagnostic accuracy (AUC = 0.993) for distinguishing FTD from CU. Furthermore, OCTA metrics, particularly reduced SVC density, were significantly associated with increased SVD burden, indicating a link between retinal microvascular changes and cerebral small vessel pathology in FTD.

Discussion

Our findings support a retina–brain microvascular axis in FTD, where retinal microvascular alterations may reflect cerebral SVD burden. These results highlight the potential of OCTA as a noninvasive biomarker for monitoring vascular contributions to frontotemporal neurodegeneration. The study provides a framework that using OCTA-derived metrics may help improve early diagnosis, disease stratification, and monitoring of vascular involvement in FTD.