Macular vessel density in the superficial plexus is not a proxy of cerebrovascular damage in non-demented individuals: data from the NORFACE cohort
Authors: García-Sánchez Ainhoa , Sotolongo-Grau Oscar , Tartari Juan Pablo , Sanabria Ángela , Esteban - De Antonio Ester , Pérez-Cordón Alba , Alegret Montserrat , Pytel Vanesa , Martínez Joan , Aguilera Núria , de Rojas Itziar , Cano Amanda , García-González Pablo , Puerta Raquel , Olivé Clàudia , Capdevila Maria , García-Gutiérrez Fernando , Vivas Assumpta , Gómez-Chiari Marta , Giménez Juan , Tejero Miguel Ángel , Castilla-Martí Miguel , Castilla-Martí Luis , Tárraga Lluís , Valero Sergi , Ruiz Agustín , Boada Mercè , Marquié Marta ,   on behalf of the FACEHBI study group, Alllué J. A. , Appiani F. , Ariton D. M. , Berthier M. , Bojayrin U. , Buendia M. , Bullich S. , Campos F. , Castillo S. , Cañabate P. , Cañada L. , Cuevas C. , Diego S. , Espinosa A. , Gailhajenet A. , Guitart M. , Ibarria M. , Lafuente A. , Lleonart N. , Lomeña F. , Martín E. , Moreno M. , Morera A. , Montrreal L. , Niñerola A. , Nogales A. B. , Núñez L. , Orellana A. , Ortega G. , Páez A. , Pancho A. , Pelejà E. , Pérez-Martínez E. , Pérez-Grijalba V. , Pascual-Lucas M. , Perissinotti A. , Preckler S. , Ricciardi M. , Roé-Vellvé N. , Romero J. , Ramis M. I. , Rosende-Roca M. , Sarasa M. , Seguer S. , Stephens A. W. , Terencio J. , Torres M. , Vargas L. ,   on behalf of the BIOFACE study group, Appiani F. , Ariton D. M. , Bojayrin U. , Buendía M. , Calvet A. , Castillón M. J. , Cañabate P. , Cañada L. , Cuevas C. , de Rojas I. , Diego S. , Espinosa A. , Gailhajenet A. , Guitart M. , Ibarria M. , Lafuente A. , Lleonart N. , Martín E. , Moreno M. , Morera A. , Montrreal L. , Nogales A. B. , Orellana A. , Ortega G. , Pancho A. , Preckler S. , Ricciardi M. , Ramis M. I. , Rosende-Roca M. , Seguer S. , Vargas L. 
Published: February 2024

Abstract
Introduction
Optical coherence tomography angiography (OCT-A) is a novel tool that allows the detection of retinal vascular changes. We investigated the association of macular vessel density (VD) in the superficial plexus assessed by OCT-A with measures of cerebrovascular pathology and atrophy quantified by brain magnetic resonance imaging (MRI) in non-demented individuals.

Methods
Clinical, demographical, OCT-A, and brain MRI data from non-demented research participants were included. We analyzed the association of regional macular VD with brain vascular burden using the Fazekas scale assessed in a logistic regression analysis, and the volume of white matter hyperintensities (WMH) assessed in a multiple linear regression analysis. We also explored the associations of macular VD with hippocampal volume, ventricle volume and Alzheimer disease cortical signature (ADCS) thickness assessed in multiple linear regression analyses. All analyses were adjusted for age, sex, syndromic diagnosis and cardiovascular variables.

Results
The study cohort comprised 188 participants: 89 with subjective cognitive decline and 99 with mild cognitive impairment. No significant association of regional macular VD with the Fazekas categories (all, p > 0.111) and WMH volume (all, p > 0.051) were detected. VD in the nasal quadrant was associated to hippocampal volume (p = 0.007), but no other associations of macular VD with brain atrophy measures were detected (all, p > 0.05).

Discussion
Retinal vascular measures were not a proxy of cerebrovascular damage in non-demented individuals, while VD in the nasal quadrant was associated with hippocampal atrophy independently of the amyloid status.