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Eye Could Provide ‘Window to the Brain’ After Stroke

a close up of an older man's eyes

A chemical given to stroke patients undergoing brain scans can leak into the eyes, perhaps providing insight into strokes, study says.

Photo: duncan1890/Istock

Research into curious bright spots in the eyes on stroke patients’ brain images could one day alter the way these individuals are assessed and treated. A team of NIH scientists found that a chemical routinely given to stroke patients undergoing brain scans can leak into their eyes, highlighting those areas and potentially providing insight into their strokes. The study was published in Neurology.

“We were kind of astounded by this—it’s a very unrecognized phenomenon,” said Dr. Richard Leigh, an assistant clinical investigator at NINDS and the paper’s senior author. “It raises the question of whether there is something we can observe in the eye that would help clinicians evaluate the severity of a stroke and guide us on how best to help patients.”

The eyes glowed so brightly on those images due to gadolinium, a harmless, transparent chemical often given to patients during magnetic resonance imaging scans to highlight abnormalities in the brain. In healthy individuals, gadolinium remains in the blood stream and is filtered out by the kidneys. However, when someone has experienced damage to the blood-brain barrier, which controls whether substances in the blood can enter the brain, gadolinium leaks into the brain, creating bright spots that mark the location of brain damage.

Previous research had shown that certain eye diseases could cause a similar disruption to the blood-ocular barrier, which does for the eye what the blood-brain barrier does for the brain. Leigh’s team discovered that a stroke can also compromise the blood-ocular barrier and that the gadolinium that leaked into a patient’s eyes could provide information about his or her stroke.

“It looks like the stroke is influencing the eye, and so the eye is reflective of what is going on in the brain,” Leigh said. “Clearly these results are preliminary, so future studies will have to be attuned to this to fully understand its impact.”
 

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