Association of Retinal Biomarkers With the Subtypes of Ischemic Stroke and an Automated Classification Model

Xiong, Zhouwei1,2; Kwapong, William R.3; Liu, Shouyue1,2; Chen, Tao1,2; Xu, Keyi1,2; Mao, Haiting1,2; Hao, Jinkui1; Cao, Le3; Liu, Jiang4; Zheng, Yalin5; Wang, Hang3; Yan, Yuying3; Ye, Chen3; Wu, Bo3; Qi, Hong6; Zhao, Yitian1,2

2024-08-01

10.1167/iovs.65.8.50

INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE   影响因子和分区

0146-0404

1552-5783

P URPOSE . Retinal microvascular changes are associated with ischemic stroke, and optical coherence tomography angiography (OCTA) is a potential tool to reveal the retinal microvasculature. We investigated the feasibility of using the OCTA image to automatically identify ischemic stroke and its subtypes (i.e. lacunar and non-lacunar stroke), and exploited the association of retinal biomarkers with the subtypes of ischemic stroke. M ETHODS . Two cohorts were included in this study and a total of 1730 eyes from 865 participants were studied. A deep learning model was developed to discriminate the subjects with ischemic stroke from healthy controls and to distinguish the subtypes of ischemic stroke. We also extracted geometric parameters of the retinal microvasculature at different retinal layers to investigate the correlations. R ESULTS . Superficial vascular plexus (SVP) yielded the highest areas under the receiver operating characteristic curve (AUCs) of 0.922 and 0.871 for the ischemic stroke detection and stroke subtypes classification, respectively. For external data validation, our model achieved an AUC of 0.822 and 0.766 for the ischemic stroke detection and stroke subtypes classification, respectively. When parameterizing the OCTA images, we showed individuals with ischemic strokes had increased SVP tortuosity (B = 0.085, 95% confidence interval [CI] = 0.005-0.166, P = 0.038) and reduced FAZ circularity (B = - 0.212, 95% CI = - 0.42 to - 0.005, P = 0.045); non-lacunar stroke had reduced SVP FAZ circularity (P P = 0.027) compared to lacunar stroke. C ONCLUSIONS . Our study demonstrates the applicability of artificial intelligence (AI)- enhanced OCTA image analysis for ischemic stroke detection and its subtypes classification. Biomarkers from retinal OCTA images can provide useful information for clinical decision-making and diagnosis of ischemic stroke and its subtypes.

artificial intelligence (AI) deep learning optical coherence tomography angiography (OCTA) microvasculature ischemic stroke

SCI

英语

其他

National Science Foundation Program of China[62272444] ; Youth Innovation Promo-tion Association CAS[2021298] ; Zhejiang Provincial Natural Science Foundation of China["LR22F020008","LQ23F010007","LR24F010002","LZ23F010002"] ; Key research and development program of Zhejiang Province["2024C03101","2024C03204"] ; Key Project of Ningbo Public Welfare Science and Technology[2023S012]

Ophthalmology

Ophthalmology

WOS:001290228900005

ASSOC RESEARCH VISION OPHTHALMOLOGY INC

CLINICAL MEDICINE

Web of Science

1.Chinese Acad Sci, Ningbo Inst Mat Technol & Engn, Lab Adv Theranost Mat & Technol, Ningbo 315201, Peoples R China
2.Wenzhou Med Univ, CiXi Biomed Res Inst, Wenzhou, Zhejiang, Peoples R China
3.Sichuan Univ, West China Hosp, Dept Neurol, Chengdu, Peoples R China
4.Southern Univ Sci & Technol, Dept Comp Sci & Engn, Shenzhen, Peoples R China
5.Univ Liverpool, Dept Eye & Vis Sci, Liverpool, England
6.Peking Univ Third Hosp, Dept Ophthalmol, Beijing 100191, Peoples R China

Xiong, Zhouwei,Kwapong, William R.,Liu, Shouyue,et al. Association of Retinal Biomarkers With the Subtypes of Ischemic Stroke and an Automated Classification Model[J]. INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE,2024,65(8).

Xiong, Zhouwei.,Kwapong, William R..,Liu, Shouyue.,Chen, Tao.,Xu, Keyi.,...&Zhao, Yitian.(2024).Association of Retinal Biomarkers With the Subtypes of Ischemic Stroke and an Automated Classification Model.INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE,65(8).

Xiong, Zhouwei,et al."Association of Retinal Biomarkers With the Subtypes of Ischemic Stroke and an Automated Classification Model".INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE 65.8(2024).