Batu Oto Bilge, Kılıçarslan Oğuzhan, Kayadibi Yasemin, Yılmaz Çebi Aslıhan, Adaletli İbrahim, Yıldırım Senihe Rengin
Department of Ophthalmology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, 345098 Istanbul, Turkey.
Department of Ophthalmology, Ayancık State Hospital, 57400 Sinop, Turkey.
J Clin Med. 2023 Sep 16;12(18):6014. doi: 10.3390/jcm12186014.
We aimed to analyze retinal microvascular parameters, measured by optical coherence tomography angiography in patients with internal carotid artery stenosis compared to healthy individuals. A total of 41 eyes from 30 patients who had varying degrees of carotid stenosis, and 42 eyes from 42 healthy controls, were enrolled in this study. Depending on the degree of stenosis evaluated by Doppler ultrasonographic imaging, the patient group was further subclassified into mild, moderate, and severe carotid artery stenosis. Superficial and deep capillary plexus vessel densities, radial peripapillary capillary vessel density, foveal avascular zone, and flow densities in the choriocapillaris and outer retina were evaluated by optical coherence tomography angiography. The superficial and deep capillary plexus vessel densities were significantly reduced among the groups, only sparing the foveal region. The mean superficial plexus vessel density was 45.67 ± 4.65 and 50.09 ± 4.05 for the patient and control group, respectively ( = 0.000). The mean deep capillary plexus density was 46.33% ± 7.31% and 53.27% ± 6.31% for the patient and control group, respectively ( = 0.000). The mean superficial and deep capillary vessel densities in the foveal region did not show any statistical difference between the patient and control groups ( = 0.333 for the superficial and = 0.195 for the deep plexus vessel density). Radial peripapillary capillary vessel density was decreased in the patient group ( = 0.004). The foveal avascular zone area was wider in the patient group but this difference did not show a significant difference ( = 0.385). Retinal microvascular changes are a prominent outcome of internal carotid disease, and even mild stenosis can lead to alterations in the retinal microvascular bed which could be detected by OCTA. By early detection of microvascular changes in the retina in this patient group, we might speculate the overall vascular condition.
我们旨在分析通过光学相干断层扫描血管造影术测量的视网膜微血管参数，将患有颈内动脉狭窄的患者与健康个体进行比较。本研究共纳入了30例患有不同程度颈动脉狭窄患者的41只眼，以及42例健康对照者的42只眼。根据多普勒超声成像评估的狭窄程度，将患者组进一步细分为轻度、中度和重度颈动脉狭窄。通过光学相干断层扫描血管造影术评估浅表和深层毛细血管丛血管密度、视盘周围放射状毛细血管血管密度、黄斑无血管区以及脉络膜毛细血管和视网膜外层的血流密度。各组之间浅表和深层毛细血管丛血管密度均显著降低，仅黄斑区未受影响。患者组和对照组的平均浅表丛血管密度分别为45.67±4.65和50.09±4.05（P = 0.000）。患者组和对照组的平均深层毛细血管丛密度分别为46.33%±7.31%和53.27%±6.31%（P = 0.000）。患者组和对照组黄斑区的平均浅表和深层毛细血管血管密度未显示出任何统计学差异（浅表P = 0.333，深层丛血管密度P = 0.195）。患者组视盘周围放射状毛细血管血管密度降低（P = 0.004）。患者组黄斑无血管区面积更宽，但这种差异未显示出显著差异（P = 0.385）。视网膜微血管变化是颈内动脉疾病的一个突出结果，即使是轻度狭窄也可能导致视网膜微血管床的改变，这可以通过光学相干断层扫描血管造影术检测到。通过早期检测该患者组视网膜中的微血管变化，我们可能推测其整体血管状况。
