Department of Ophthalmology, Semmelweis University, 39 Mária Street, 1085, Budapest, Hungary.
Department of Vascular & Endovascular Surgery, Semmelweis University, Budapest, Hungary.
Geroscience. 2022 Feb;44(1):389-401. doi: 10.1007/s11357-021-00492-1. Epub 2021 Nov 27.
Carotid artery stenosis (CAS) is among the leading causes of mortality and permanent disabilities in the Western world. CAS is a consequence of systemic atherosclerotic disease affecting the majority of the aging population. Optical coherence tomography angiography (OCTA) is a novel imaging technique for visualizing retinal blood flow. It is a noninvasive, fast method for qualitative and quantitative assessment of the microcirculation. Cerebral and retinal circulation share similar anatomy, physiology, and embryology; thus, retinal microvasculature provides a unique opportunity to study the pathogenesis of cerebral small vessel disease in vivo. In this study, we aimed to analyze the effect of systemic risk factors on retinal blood flow in the eyes of patients with significant carotid artery stenosis using OCT angiography. A total of 112 eyes of 56 patients with significant carotid stenosis were included in the study. We found that several systemic factors, such as decreased estimated glomerular filtration rate (eGFR), hypertension, and carotid occlusion have a significant negative effect on retinal blood flow, while statin use and carotid surgery substantially improve ocular microcirculation. Neither diabetes, clopidogrel or acetylsalicylic acid use, BMI, serum lipid level, nor thrombocyte count showed a significant effect on ocular blood flow. Our results demonstrate that a systematic connection does exist between certain systemic risk factors and retinal blood flow in this patient population. OCTA could help in the assessment of cerebral circulation of patients with CAS due to its ability to detect subtle changes in retinal microcirculation that is considered to represent changes in intracranial blood flow.
颈动脉狭窄（CAS）是西方世界导致死亡和永久性残疾的主要原因之一。CAS 是影响大多数老年人群体的全身性动脉粥样硬化疾病的后果。光学相干断层扫描血管造影（OCTA）是一种用于可视化视网膜血流的新型成像技术。它是一种非侵入性、快速的方法，可用于对微循环进行定性和定量评估。脑和视网膜循环具有相似的解剖结构、生理学和胚胎学；因此，视网膜微血管为研究脑小血管病的发病机制提供了一个独特的机会。在这项研究中，我们旨在使用 OCT 血管造影分析全身性危险因素对颈动脉狭窄患者眼睛视网膜血流的影响。共纳入 56 例颈动脉狭窄明显的患者的 112 只眼。我们发现，一些全身性因素，如肾小球滤过率（eGFR）降低、高血压和颈动脉闭塞，对视网膜血流有显著的负影响，而他汀类药物的使用和颈动脉手术则显著改善了眼部微循环。糖尿病、氯吡格雷或乙酰水杨酸的使用、BMI、血脂水平或血小板计数均对眼血流无显著影响。我们的结果表明，在这一患者群体中，某些全身性危险因素与视网膜血流之间确实存在系统联系。OCTA 由于能够检测到视网膜微循环的细微变化，从而有助于评估 CAS 患者的脑循环，因为这些变化被认为代表了颅内血流的变化。
