This multicenter cross-sectional study compared retinal OCT/OCTA and quantitative MRI profiles in 651 participants (1,257 eyes): 228 controls, 283 patients with carotid artery stenosis-associated stroke (CAS), 74 with recent small subcortical infarct (RSSI), and 66 with chronic cerebral small vessel disease (CSVD). CAS showed the most pronounced retinal microvascular impairment, with lower vessel length density (VLD) across superficial, deep, and choriocapillaris layers than controls and RSSI, reduced ganglion cell–inner plexiform layer thickness, and lower gray and white matter volumes. All patient groups had greater white matter hyperintensity (WMH) burden than controls. In CAS, superficial vascular complex VLD was positively associated with gray matter volume and inversely associated with total and periventricular WMH; regional analyses showed broader cortical and subcortical associations. OCTA–MRI associations were less consistent and less precise in RSSI and CSVD. The authors conclude that retinal OCTA may provide complementary, subtype-relevant information in cerebrovascular disease, especially CAS, but longitudinal validation is needed.

This work, entitled “Retinal Microvascular Signatures and Retina–Brain Coupling Across Cerebrovascular Disease Subtypes: An OCTA and Quantitative MRI Study,” was published on Human Brain(published on Sep 29, 2026).
DOI：10.15302/HB.2026.0006