Enlarged perivascular spaces (EPVS) have been reported to be associated with cerebral infarction, cerebral hemorrhage or cognitive dysfunction. However, there is still a lack of relevant reports on the risk factors of EPVS, especially fundus arteriovenous crossing phenomenon and fundus exudation in patients with mild acute cerebral infarction.

To investigate the risk factors of EPVS and the association between EPVS and fundus lesions in patients with mild acute cerebral infarction.

Two hundred and sixty-six patients with mild acute cerebral infarction were retrospectively chosen from the Fifth People's Hospital of Pingdingshan and Pingdingshan the Second People's Hospital in the period from January 2015 to December 2020, including 114 with EPVS, and 152 without. General demographics, laboratory test and imaging data were collected. Multivariate Logistic regression was used to analyze the independent influencing factors of EPVS in mild acute cerebral infarction. Spearman's rank correlation and multivariate linear regression were used to analyze the correlation between the severity and number of EPVS with fundus lesions.

Among the 266 patients, 178 were male and 88 were female, with a mean age of (67.8±12.9) years. Patients with and without EPVS had significant differences in mean age, prevalence of hypertension history, mean severity of fundus arteriosclerosis, diameter of the central retinal artery, retinal arteriovenous ratio, prevalence of hemangioma and retinal arteriovenous crossing phenomenon (P<0.05) . Multivariate Logistic regression analysis showed that the history of hypertension〔OR=3.127, 95%CI (1.514, 6.457) , P=0.002〕and the severity of fundus arteriosclerosis〔OR=3.077, 95%CI (2.289, 4.137) , P<0.001〕were independent influencing factors of EPVS in mild acute cerebral infarction. Spearman's rank correlation analysis showed that the severity of EPVS was positively correlated with the severity of fundus arteriosclerosis (r_s=0.751, P<0.001) , hemangioma (r_s=0.644, P<0.001) , retinal arteriovenous crossing phenomenon (r_s=0.589, P<0.001) , and negatively correlated with the diameter of the central retinal artery (r_s=-0.342, P<0.001) , and the retinal arteriovenous ratio (r_s=-0.463, P=0.012) . Multivariate linear regression analysis showed that the number of EPVS was positively correlated with the severity of fundus arteriosclerosis〔B=0.586, 95%CI (0.345, 0.827) , P=0.016〕and retinal arteriovenous crossing phenomenon〔B=0.472, 95%CI (0.291, 0.653) , P=0.010〕, and negatively correlated with the retinal arteriovenous ratio〔B=-3.974, 95%CI (-5.548, -2.400) , P=0.012〕.

EPVS may be more likely to occur in mild acute cerebral infarction patients with hypertension and fundus arteriosclerosis, and the severity of EPVS is positively correlated with the severity of fundus arteriosclerosis, hemangioma and retinal arteriovenous crossing phenomenon, and negatively correlated with the diameter of the central retinal artery and retinal arteriovenous ratio.