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Cerebral small vessel disease (SVD), characterized by lacunar infarcts and white matter lesions on brain imaging, has been associated with important neurologic and cognitive symptoms. Although there is an established association between large artery disease and atherosclerosis, the pathophysiologic mechanisms of SVD are less clear.
Recent literature has provided accumulating evidence that SVD occurs in the context of a much broader vasculopathy that affects multiple target organs that are heavily perfused, including the retina, heart, lung, liver, and kidney.1 In addition, there have been several studies that have found an association between retinal vessel abnormalities and white matter lesions,2 a radiologic marker of SVD and surrogate for cardiovascular function.3 Therefore, the study of retinal vessels may provide a unique opportunity to examine in vivo alterations of the health of penetrating cerebral small vessels. Relevant to the study of cerebral SVD, the retina …
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