Retinal microvascular network alterations: potential biomarkers of cerebrovascular and neural diseases

Am J Physiol Heart Circ Physiol. 2017 Feb 1;312(2):H201-H212. doi: 10.1152/ajpheart.00201.2016. Epub 2016 Dec 6.


Increasing evidence suggests that the conditions of retinal microvessels are indicators to a variety of cerebrovascular, neurodegenerative, psychiatric, and developmental diseases. Thus noninvasive visualization of the human retinal microcirculation offers an exceptional opportunity for the investigation of not only the retinal but also cerebral microvasculature. In this review, we show how the conditions of the retinal microvessels could be used to assess the conditions of brain microvessels because the microvascular network of the retina and brain share, in many aspects, standard features in development, morphology, function, and pathophysiology. Recent techniques and imaging modalities, such as optical coherence tomography (OCT), allow more precise visualization of various layers of the retina and its microcirculation, providing a "microscope" to brain microvessels. We also review the potential role of retinal microvessels in the risk identification of cerebrovascular and neurodegenerative diseases. The association between vision problems and cerebrovascular and neurodegenerative diseases, as well as the possible role of retinal microvascular imaging biomarkers in cerebrovascular and neurodegenerative screening, their potentials, and limitations, are also discussed.

Keywords: brain; cerebrovascular and neurodegenerative disorders; optical coherence tomography; optical imaging; retinal imaging biomarkers.

Publication types

  • Review

MeSH terms

  • Angiography
  • Brain
  • Cerebrovascular Circulation
  • Cerebrovascular Disorders / diagnostic imaging*
  • Cerebrovascular Disorders / pathology
  • Fundus Oculi
  • Humans
  • Microvessels / diagnostic imaging*
  • Microvessels / pathology
  • Neurodegenerative Diseases / diagnostic imaging*
  • Neurodegenerative Diseases / pathology
  • Neurons / pathology
  • Retinal Ganglion Cells / pathology*
  • Retinal Vessels / diagnostic imaging*
  • Retinal Vessels / pathology
  • Tomography, Optical Coherence