Insights From the Retina on Cerebral Microvascular Dysfunction in Haemorrhagic Stroke

The purpose of the study is to

• To evaluate the feasibility of fundoscopy, OCT and OCTA imaging in the environment of a Neurocritical Care Unit (NCCU)
• To detect, quantify and associate microvascular changes in the retina with signs of micro-vessel disease in ICH and DCI in aSAH

Inclusion criteria

• All groups

• Primary ICH or aSAH with symptoms onset < 3 days
• 18 to unlimited years of age
• Signed informed consent obtained from legal representative or patient ICH group
• Primary ICH localized either in basal ganglia, thalamus, pons or cerebellum aSAH group
• Ruptured aneurysm visualized in contrast-enhanced computed tomography (angio-CT), MRI or cerebral angiography Control group
• Stroke due to perimesencepahlic subarachnoid hemorrhage, arteriovenous malformation or isolated traumatic brain injury

Exclusion criteria

• All groups

• Cerebral amyloid angiopathy or other neurodegenerative disease
• History of migraine with aura or ischemic stroke
• Contraindication for pupil dilation (intracranial hypertension, allergy against mydriatics, angle closure glaucoma)
• Any pre-existing or manifest ocular condition affecting either the integrity of retinal vessels, transparency of optical media or the risk of acute angle closure glaucoma
• Concomitant instable critical illness (e.g. sepsis, multi-organ failure)
• Intracranial pressure > 20mmHg and refractory to cerebrospinal fluid drainage
• Pregnancy