Background/aim This study aimed to explore the value of radiological and radiomic features retrieved from magnetic resonance imaging in the prediction of a Ki-67 proliferative index in meningioma patients using a machine learning model. Methods This multicenter, retrospective study included 371 patients collected from two centers. The Ki-67 expression was classified into low-expressed and high-expressed groups with a threshold of 5%. Clinical features and radiological features were collected and analyzed by using univariate and multivariate statistical analyses. Radiomic features were extracted from contrast-enhanced images, followed by three independent feature selections. Six predictive models were constructed with different combinations of features by using linear discriminant analysis (LDA) classifier. Results The multivariate analysis suggested that the presence of intratumoral necrosis (p = 0.032) and maximum diameter (p < 0.001) were independently correlated with a high Ki-67 status. The predictive models showed good performance with AUC of 0.837, accuracy of 0.810, sensitivity of 0.857, and specificity of 0.771 in the internal test and with AUC of 0.700, accuracy of 0.557, sensitivity of 0.314, and specificity of 0.885 in the external test. Conclusion The results of this study suggest that the predictive model can efficiently predict the Ki-67 index of meningioma patients to facilitate the therapeutic management.

Background: Retinal ischemic perivascular lesions (RIPLs) are an indicator of ischemia in the middle retina. We aimed to determine the relationship between RIPLs and single subcortical infarction (SSI). We also investigated the differences in cerebral small vessel disease imaging burden between groups with and without RIPLs in SSI. Methods and Results: In this case–control study, we enrolled 82 patients with SSI and 72 nonstroke controls. All participants underwent magnetic resonance imaging and swept‐source optical coherence tomography/optical coherence tomography angiography. Small vessel disease markers such as lacunes, cerebral microbleeds, white matter hyperintensity, and perivascular spaces were rated on brain imaging. RIPLs were assessed via swept‐source optical coherence tomography. Optical coherence tomography angiography was used to measure the superficial vascular complex and deep vascular complex of the retina. After adjusting for risk factors, the presence of RIPLs was significantly associated with SSI (odds ratio [OR], 1.506 [95% CI, 1.365–1.662], P <0.001). Eyes with RIPLs showed lower deep vascular complex density ( P =0.035) compared with eyes without RIPLs in patients with SSI. After adjusting for vascular risk factors, the presence of RIPLs in patients with SSI was associated with an increased periventricular white matter hyperintensity burden (β=0.414 [95% CI, 0.181–0.647], P <0.001) and perivascular spaces‐basal ganglia (β=0.296 [95% CI, 0.079–0.512], P =0.008). Conclusions: RIPLs are associated with SSI independent of underlying risk factors. The relationship between the presence of RIPLs and small vessel disease markers provides evidence that RIPLs might be an additional indicator of cerebral ischemic changes.

Introduction: It is suggested that cerebral small vessel disease (SVD) plays a role in strokes and dementia. Retinal microvasculature imaged by optical coherence tomography angiography (OCTA) is suggested to be associated with cerebral microvessels. We measured the density of the retinal arterioles and venules on the superficial vascular complex (SVC) of OCTA images and investigated associations with SVD markers in older adults.Methods: Participants underwent cerebral magnetic resonance imaging and OCTA imaging. An external algorithm (OCTA‐Net) was used to segment the retinal vessels into arterioles and venules. SVD indicators [lacunes, white matter hyperintensity (WMH), perivascular spaces (PVS) and cerebral microbleeds (CMBs)] were determined according to the STandards for ReportIng Vascular changes on nEuroimaging (STRIVE)Results: 246 older adults (mean age = 58.84 ± 7.00 years; 38.21 % males) were included in our data analysis. After adjusting for covariates, lower retinal arteriole densities correlated with higher periventricular WMH (p = 0.025) and PVS in the basal ganglia (p = 0.027). Lower retinal venule density correlated with higher deep WMH burden (p = 0.014). Lower arteriolar density was associated with increased SVD burden (p = 0.035). Arteriolar complex branching was associated with periventricular WMH (p = 0.020) while venular complex branching was associated with deep WMH (p = 0.041).Conclusion: Retinal vascular changes may reflect cerebral vascular changes as evidenced by OCTA‐derived metrics.

Introduction This study explored the structural and microvascular changes in the optic nerve head (ONH) of patients with intracranial hypertension (IH) by using swept-source optical coherence tomography (SS-OCT)/OCT angiography (OCTA) and evaluated their association with clinical features. Methods The optic disc morphology, peripapillary retinal nerve fiber layer (pRNFL), ganglion cell–inner plexiform layer (GCIPL), and microvascular densities of the nerve fiber layer plexus (NFLP), superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) were measured by the SS-OCT/OCTA tool. Frisen score, visual acuity, and intracranial pressure were assessed and recorded in patients with IH. Results Sixty-one patients with IH and 65 controls were included in this study. Patients with IH showed thicker pRNFL and GCIPL thickness with larger ONH rim area when compared to controls (P < 0.001). Microvascular densities were increased in NFLP while densities were reduced in SVP, ICP, and DCP when compared to controls (P < 0.001). Structural thickness and microvascular densities were significantly correlated with Frisen scores (P < 0.05) and intracranial pressure (P < 0.05) in patients with IH. Conclusion Structural and microvasculature variations of the ONH were found in patients with IH compared to controls. Importantly, we showed that structural and microvascular changes in the ONH were correlated with their Frisen score and intracranial pressure in patients with IH.

Background: Reports have proposed the retinal choroid as a potential biomarker for dementia and cerebral age‐related disorders. However, the clinical use of the choroid as a surrogate marker remains underexplored. This study investigated the associations among choroidal perfusion, white matter hyperintensity (WMH), and cognitive function. Methods: WMH severity (volume and shape features) and choroidal characteristics, including choroidal vascular volume, choroidal vascularity index, and choriocapillaris flow density, were automatically quantified in aging adults. Partial Spearman correlation was used to examine the relationship between choroidal and WMH metrics. General linear models were used to examine the associations of choroidal metrics and WMH characteristics with cognitive performance, as well as to explore potential interaction effects, whereas generalized estimating equations were applied to account for within‐subject correlations in eye‐specific data. Results: A total of 197 participants were included in the study. Choroidal vascular volume and choroidal vascular index were inversely correlated with total and periventricular WMH volumes. Irregular WMH shape and reduced choroidal vascular volume were both associated with poorer memory performance. A significant interaction was found between choroidal perfusion and periventricular WMH shape on memory, suggesting that the relationship between WMH features and memory function may be more pronounced in individuals with lower choroidal perfusion. Conclusions: The severity of WMH and the status of choroidal perfusion may jointly reflect memory performance, suggesting ischemia as a potential shared mechanism. Future research is warranted to assess the clinical usefulness of WMH and choroidal metrics in predicting cognitive decline.

Aims: Cerebrovascular lesions in the primary visual cortex, the lateral geniculate nucleus, and the optic tract have been associated with retinal neurodegeneration via the retrograde degeneration (RD) mechanism. We aimed to use optical coherence tomography (OCT) to assess the effects of the strategic single subcortical infarction (SSI) location on retinal neurodegeneration and its longitudinal impacts.Methods: Patients with SSI were enrolled and stratified by lesion location on cerebral MRI into the thalamic infarction group and extra‐thalamic infarction group. Healthy controls from the native communities were also recruited. Retinal nerve fiber layer (RNFL) and ganglion cell‐inner plexiform layer (GCIPL) were quantified using OCT. Generalized estimating equation (GEE) models were used for cross‐sectional analyses and linear mixed models for longitudinal analyses. P < 0.05 was considered statistically significant.Results: We included a total of 283 eyes from 149 SSI patients. Of these, 115 eyes of 60 patients with follow‐up were included in the longitudinal analyses. Cross‐sectionally, thalamic‐infarction patients had reduced retinal thickness compared with extra‐thalamic infarction patients after adjustment for age, gender, disease duration, and vascular risk factors (p = 0.026 for RNFL, and p = 0.026 for GCIPL). Longitudinally, SSI patients showed greater retinal thinning compared with healthy controls over time (p = 0.040 for RNFL, and p < 0.001 for GCIPL), and thalamic infarction patients exhibited faster rates of GCIPL thinning in comparison with extra‐thalamic infarction patients (p < 0.001).Conclusion: Our study demonstrates a distinct effect of subcortical infarction lesion site on the retina both at the early stage of disease and at the 1‐year follow‐up time. These results present evidence of significant associations between strategic infarction locations and retinal neurodegeneration. It may provide novel insights for further research on RD in stroke patients and ultimately facilitate individualized recovery therapeutic strategy.