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Retinal vascular reactivity is associated with white matter hyperintensities and dysfunctional cerebrovascular reactivity in cerebral small vessel disease
Gordon W. Blair, Ian J. C. MacCormick, Sarah McGrory, Tom MacGillivray, Iona F. Hamilton, Yulu Shi, Francesca M. Chappell, Michael J. Thrippleton et al.. Journal of Cerebral Blood Flow & Metabolism, 2025-08-06
Topic: Brain proteins, microglia and lab models
Cerebral small vessel disease (cSVD) is characterised by white matter hyperintensities (WMH) and contributes to stroke and dementia. Cerebrovascular reactivity (CVR) declines with worsening cSVD but estimates of CVR from brain scans give limited information about the coordination of individual arterioles or venules. Retinovascular reactivity can provide separate data about arterioles and venules, but it is not known if retinovascular reactivity correlates with CVR in people with cSVD. We aimed to assess retinal vascular reactivity in people with cSVD and explore associations with WMH and CVR in a cross-sectional study. Participants had retinal photographs and magnetic resonance brain imaging (MRI) before and during inhalation of 6% CO 2 in air. We recruited 60 participants. 48 provided analysable retinal vessel reactivity data. Retinal arteriole/venule ratio was inversely related to WMH severity (adjusted R2 = 0.47 β–5.2 95%CI–7.9 to −2.5) and directly related to CVR (adjusted R2 = 0.21 β0.15 95%CI 0.04 to 0.25). In general, participants whose arteriole/venule ratio increased with CO 2 had milder WMH and higher (better) CVR, while participants whose arteriole/venule ratio decreased had more severe WMH and lower (worse) CVR. Retinovascular reactivity to CO 2 inhalation in people with cSVD suggests loss of normal arteriovenous coordination and inefficient perfusion of the capillary bed.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Blair, G. W., MacCormick, I. J. C., McGrory, S., MacGillivray, T., Hamilton, I. F., Shi, Y., et al. (2025). Retinal vascular reactivity is associated with white matter hyperintensities and dysfunctional cerebrovascular reactivity in cerebral small vessel disease. Journal of Cerebral Blood Flow & Metabolism. https://doi.org/10.1177/0271678x251366079
Vancouver
Blair GW, MacCormick IJC, McGrory S, MacGillivray T, Hamilton IF, Shi Y, et al. Retinal vascular reactivity is associated with white matter hyperintensities and dysfunctional cerebrovascular reactivity in cerebral small vessel disease. Journal of Cerebral Blood Flow & Metabolism. 2025. doi:10.1177/0271678x251366079. PMID: 40770920.
BibTeX
@article{blair2025-40770920,
author = {Blair, Gordon W. and MacCormick, Ian J. C. and McGrory, Sarah and MacGillivray, Tom and Hamilton, Iona F. and Shi, Yulu and Chappell, Francesca M. and Thrippleton, Michael J. and others},
title = {{Retinal vascular reactivity is associated with white matter hyperintensities and dysfunctional cerebrovascular reactivity in cerebral small vessel disease}},
journal = {Journal of Cerebral Blood Flow \& Metabolism},
year = {2025},
doi = {10.1177/0271678x251366079},
pmid = {40770920},
url = {https://doi.org/10.1177/0271678x251366079}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Participants had retinal photographs and magnetic resonance brain imaging (MRI) before and during inhalation of 6% CO 2 in air.
- We recruited 60 participants. 48 provided analysable retinal vessel reactivity data.
- Retinal arteriole/venule ratio was inversely related to WMH severity (adjusted R2 = 0.47 β–5.2 95%CI–7.9 to −2.5) and directly related to CVR (adjusted R2 = 0.21 β0.15 95%CI 0.04 to 0.25).
- In general, participants whose arteriole/venule ratio increased with CO 2 had milder WMH and higher (better) CVR, while participants whose arteriole/venule ratio decreased had more severe WMH and lower (worse) CVR.
- Retinovascular reactivity to CO 2 inhalation in people with cSVD suggests loss of normal arteriovenous coordination and inefficient perfusion of the capillary bed.
Why it matters
In this cross-sectional study of 60 participants, retinal arteriole/venule ratio was inversely related to white matter hyperintensity severity and directly related to cerebrovascular reactivity, suggesting loss of normal arteriovenous coordination in small vessel disease. This is an observational imaging finding and does not test any treatment, cure, or prevention for Alzheimer's disease.
Study details
- Study designcross-sectional
- Participants60
- Evidence strengthLow
How this study scored 48/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Cerebral Blood Flow & Metabolism) |
| Journal's citation record | 3 / 4 | Journal of Cerebral Blood Flow & Metabolism: journal h-index 285 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 60 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 1.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Joanna Marguerite Wardlaw: h-index 150 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Edinburgh: institution h-index 1,378 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40770920) |
| Free to read | 2 / 2 | Free to read |
| Total | 48 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1177/0271678x251366079
- PubMed: 40770920
- Original source →
- Free full text: Journal of Cerebral Blood Flow & Metabolism →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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