Monferrer-Adsuara Clara, Remolí-Sargues Lidia, Navarro-Palop Catalina, Cervera-Taulet Enrique, Montero-Hernández Javier, Medina-Bessó Pascual, Castro-Navarro Verónica
Departamento de Oftalmología, Hospital General Universitario de Valencia, Valencia, Spain.
Departamento de Fisiología Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, Spain.
Eur J Ophthalmol. 2025 Jan;35(1):324-334. doi: 10.1177/11206721241265388. Epub 2024 Jul 26.
Ocular ischemic syndrome can be the first and only hint of life-threatening carotid artery disease. The early recognition of carotid stenosis-related retinal signs, as well as the comprehension of the pathophysiology behind retinal changes could become relevant for physicians to predict the risk of stroke. The aim of this study is to assess the carotid artery disease-induced early structural retinochoroidal changes by means of swept-source optical coherence tomography (SS-OCT).
A prospective observational study was conducted in 72 eyes with carotid stenosis. According to the degree of stenosis, the participants were divided into a normal group (34 eyes), a mild-moderate stenosis group (22 eyes), a severe stenosis group (16 eyes). SS-OCT and OCTA were performed to scan macular fovea. Central macular thickness (CMT), subfoveal choroidal thickness (SCT) and foveal avascular zona (FAZ) area were the major measurements for our study.
CMT was significantly thicker in group 3 when compared to group 2 and 1. SCT was significantly thinner in group 3 vs group 1, being thicker in group 2 when compared to group 1. No significant differences were obtained when comparing FAZ in the superficial and middle capillary plexus although it was significant when comparing the FAZ in the deep capillary plexus between group 1 and 3.
internal carotid artery stenosis greater than 70% leads to a significant increase in CMT and a decrease in SCT prior the development of clinical findings of ocular ischemia syndrome.
眼部缺血综合征可能是危及生命的颈动脉疾病的首个也是唯一线索。早期识别与颈动脉狭窄相关的视网膜体征,以及理解视网膜变化背后的病理生理学,对于医生预测中风风险可能具有重要意义。本研究的目的是通过扫频光学相干断层扫描(SS-OCT)评估颈动脉疾病引起的早期视网膜脉络膜结构变化。
对72只患有颈动脉狭窄的眼睛进行了一项前瞻性观察研究。根据狭窄程度,将参与者分为正常组(34只眼)、轻度至中度狭窄组(22只眼)、重度狭窄组(16只眼)。采用SS-OCT和光学相干断层扫描血管造影(OCTA)对黄斑中心凹进行扫描。中心黄斑厚度(CMT)、黄斑中心凹下脉络膜厚度(SCT)和黄斑无血管区(FAZ)面积是本研究的主要测量指标。
与第2组和第1组相比,第3组的CMT明显更厚。与第1组相比,第3组的SCT明显更薄,与第1组相比,第2组的SCT更厚。比较浅表和中间毛细血管丛中的FAZ时未发现显著差异,尽管比较第1组和第3组深层毛细血管丛中的FAZ时存在显著差异。
在眼部缺血综合征临床症状出现之前,颈内动脉狭窄大于70%会导致CMT显著增加和SCT降低。