OBJECTIVES: This study investigated the correlation between retinal vasculature and cerebral small vessel disease (CSVD) imaging markers, providing new evidence for the retina-brain association. METHODS: Two hundred and thirty-nine participants aged 55-85 were enrolled in the study. CSVD indicators, encompassing white matter hyperintensities (WMHs), lacunes (LAs), cerebral microbleeds (CMBs), and enlarged perivascular spaces (EPVSs), were assessed. The vascular density (VD) of the superficial vascular plexus (SVP) and deep vascular plexus (DCP) was evaluated using optical coherence tomography angiography (OCTA). Furthermore, the software automatically calculated SVP's small vessel density (sVD). Finally, the area, perimeter, circularity index (CI), and VD-300 μm of the foveal avascular zone (FAZ) were assessed utilizing OCTA. The mean values of binocular OCTA parameters were used for data analysis. The association between OCTA parameters and CSVD imaging markers was evaluated using binary logistic regression analysis. RESULTS: The median age was 68 (64-71) years with 40.2 % of the participants being male. In the binary logistic regression analysis, WMHs exhibited a negative association with the SVP-VD, DCP-VD, and FAZ VD-300 μm (P <
0.05)
LAs displayed a negative correlation with the SVP-sVD and SVP-VD (P <
0.05)
and EPVSs indicated a negative correlation with both the area and perimeter of the FAZ (P <
0.05)
however, CMBs did not demonstrate any significant correlation with OCTA indicators (P >
0.05). CONCLUSIONS: The study demonstrated that different CSVD indicators are associated with distinct OCTA markers. OCTA may be a valuable tool for monitoring CSVD-related indicators.