Ischemic stroke can lead to disruption in the oral ecology and an overgrowth of pathogenic bacteria, resulting in periodontal disease. Meanwhile, the aspiration and pulmonary infection resulted from dysphagia can increase the unfavorable prognosis. Some studies have found that there exist oral bacteria in the thrombus in myocardial infarction and ischemic stroke patients, showing that oral flora might be associated with thrombus and stroke-associated pneumonia. There are few high quality clinical studies or evidence-based guidelines. Priority should be given to high quality research that provides oral care standards, and incorporating oral care into future stroke pathways to improve the prognosis.
ObjectiveTo observe the changes of choroid, macular microcirculation and retinal light sensitivity (MS) in people with different degrees of myopia and emmetropia, and to analyze the relationship between them and the axial length (AL).MethodsA cross-sectional observational study. From May 2019 to November 2020, 142 people (142 eyes) of different degrees of myopia and volunteers from Nanchang Aier Eye Hospital were included in the study. All subjects underwent comprehensive optometry, OCT angiography (OCTA), micro-perimetry examination, and axial length (AL) measurement. A frequency domain OCTA instrument was used to measure the blood flow density of the superficial retinal capillary plexus (SVD), the blood flow density of the deep capillary plexus (DVD), the area of the foveal avascular zone (FAZ) and the choroidal capillaries in the 6 mm×6 mm area of the macula, and percentage of vascular blood flow blank area (FD). The macular integrity assessment instrument was used to measure macular 10° retinal MS and macular fovea 2°, 4° fixation rate (P1, P2), 63% and 95% hyperbolic ellipse area (BCEA). Pairwise comparisons between groups were tested by the least significant difference method.ResultsAmong 142 eyes, 68 eyes were in male, 74 eyes were in female. According to different equivalent spherical powers (SER), subjects were divided into emmetropia group, low myopia group, moderate myopia group, and high myopia group, with 31 eyes, 36 eyes, 44 eyes, and 31 eyes, respectively. Compared with SER (H=132.776) and AL (F=61.118) of the tested eyes in the 4 groups, the difference was statistically significant. The SVD (P=0.003, 0.002, 0.003) and DVD (P＜0.001,＜0.001, P=0.001) of the emmetropia group, low myopia group, and moderate myopia group were higher than those of the high myopia group, and the difference was statistically significant. The FAZ area of the emmetropia group was higher than that of the moderate myopia group, the difference was statistically significant (P=0.013). The FD percentage of choroidal capillaries in the moderate myopia group and the high myopia group was higher than that of the emmetropia group, the difference was statistically significant (P=0.011, 0.030). MS in the high myopia group was significantly lower than that in the emmetropia group, low myopia group, and moderate myopia group, the difference was statistically significant (P＜0.001,＜0.001, P=0.035). Compared with 63% BCEA, 95% BCEA, P1 and P2 among subjects in the emmetropia group, low myopia group, moderate myopia group, and high myopia group, the difference was not statistically significant (H=6.936, 7.041, 5.450, 4.239; P>0.05). The results of correlation analysis showed that the macular area SVD (r=－0.256, P=0.002), DVD (r=－0.465, P＜0.001), FAZ area (r=－0.308, P＜0.001) were negatively correlated with AL. The percentage of FD of choroidal capillaries was positively correlated with AL (r=0.170, P=0.043). Retinal MS was positively correlated with SVD (r=0.252, P=0.003), DVD (r=0.298, P＜0.001), FAZ area (r=0.334, P＜0.001), it was negatively correlated with AL (r=－0.439, P＜0.001), it was not related to the percentage of FD of choroidal capillaries (r=－0.061, P=0.473).ConclusionsWith the increase of myopic refractive power and AL, the macular area SVD, DVD, and retinal MS all show a downward trend. The decline of retinal MS is related to the decrease of SVD and DVD.
Periodontal disease is a common chronic infectious disease targeting the connective tissue supporting the dentition. In recent years, the research on periodontal disease and cerebral infarction has been increasing. However, the causal relationship between periodontal disease and cerebral infarction remains unclear. Periodontal disease may be associated with atherosclerosis, which is one of the major causes of cerebral infarction. Regular dental care can reduce the risk of cardiovascular disease. Therefore, investigating the above association and its underlying mechanisms is of great clinical significance, which may help clinicians to make appropriate treatment and prevention measures. In this paper, the research progress and possible mechanism of the relationship between periodontal disease and cerebral infarction were reviewed.
As a major disease that seriously endangers the health of Chinese residents, stroke has various triggering factors, among which infection is one of the initial factors. Previous studies have indicated a correlation of common oral infectious diseases such as periodontitis with the occurrence of stroke. However, there is a lack of effective integration of previous research on the induction of stroke by common oral infectious diseases. This article provides a comprehensive review of the relevant research on infectious diseases and stroke, with a particular focus on the progress related to periodontitis, gingivitis, dental caries, and pulpitis as triggers for stroke. It puts forward relevant recommendations for promoting oral health, so as to provide a theoretical basis for improving oral health literacy of Chinese residents and reducing the incidence of stroke and other major diseases.