Barca Irina Cristina, Potop Vasile, Arama Stefan Sorin
Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Diagnostics (Basel). 2025 May 30;15(11):1393. doi: 10.3390/diagnostics15111393.
: Our study evaluated the correlation between internal carotid artery stenosis (ICAS) and retinal microvascular changes in patients with hypertensive retinopathy, dyslipidemia and ICAS. We analyzed vascular measurements provided by optical coherence tomography angiography (OCTA) and carotid Doppler ultrasonography (US) and linked OCTA parameters with carotid artery US measurements on the same side. Statistical differences in OCTA analysis among three groups (no stenosis, mild stenosis and moderate stenosis) were evaluated and correlated with carotid Doppler parameters. Our study aimed to evaluate whether OCTA can be proposed as a screening method in patients diagnosed with mild and moderate ICAS in order to improve the early detection of carotid changes, thus potentially reducing the rate of cardiovascular and cerebral complications of ICAS. : We conducted a study on hypertensive patients with ICAS using six OCTA parameters in the analysis of the retinal vasculature and carotid Doppler US velocities of three carotid arteries and the vertebral artery (VA). Kruskal-Wallis and Dunn's post hoc tests were used to determine whether there were statistically significant differences between the normal, mild and moderate stenosis groups. Spearman and Pearson correlation were used to obtain correlations among OCTA parameters such as the foveal avascular zone (FAZ), non-flow area (NFA), vascular flow area (VFA) and blood flow velocity on carotid Doppler US. : In the final analysis, 49 patients were included and 3 groups of stenosis were obtained, comprising 21 subjects with no stenosis, 19 with mild stenosis and 9 with moderate stenosis. Right eye and left eye groups were formed. In the right eye group with right ICAS, we found statistically significant results for FAZ circularity when comparing the normal stenosis group to the mild stenosis group ( = 0.025) and the mild stenosis group to the moderate stenosis group ( = 0.006). Statistically significant results were also observed for NFA when comparing the normal stenosis group to the moderate stenosis group ( = 0.004) and the mild stenosis group to the moderate stenosis group ( = 0.011). When comparing the FAZ area ( = 0.016) and VFA ( = 0.037) for the normal and moderate groups, statistically significant values were obtained. When comparing the normal and moderate stenosis groups with regard to the left eye, we found statistically significant results for VFA ( = 0.041), NFA ( = 0.045) and VFA ( = 0.029). When comparing the mild and moderate carotid artery stenosis groups, we obtained statistically significant results for NFA ( = 0.001), FAZ area ( = 0.007) and VFA ( = 0.013). In the right eye group, correlations between internal carotid artery (ICA) peak systolic velocity (PSV) and VFA (rho = -0.286), ICA end-diastolic velocity (EDV) and NFA (r = 0.365), external carotid artery (ECA) PSV and VFA (r = -0.288; rho = -0.317), common carotid artery (CCA) PSV and NFA (rho = -0.345), CCA EDV and NFA (rho = -0.292) and VA PSV and VFA (r = -0.327; rho = -0.379) were found. When analyzing OCTA parameters, we found statistically significant results for NFA and VFA (r = -0.374; rho = -0.288). Correlations were also found in the left eye group between ICA PSV and NFA (r = -0.351; rho = -0.313), ICA EDV and VFA (r = -0.421; rho = -0.314), ECA PSV and NFA (r = -0.412; rho = -0.457), CCA PSV and NFA ( = -0.288; rho = -0.339), and CCA EDV and NFA (r = -0.404; rho = -0.417). : Our study found correlations between carotid Doppler velocities and OCTA vascular flow parameters; thus, OCTA may be used as a tool for monitoring the microvascular changes associated with carotid stenosis. OCTA can provide insights concerning the overall vascular condition of the patient, since it provides subjective data on vessel density and flow; therefore, by monitoring hypertensive patients with both OCTA and carotid Doppler US, we may be able to increase efficiency in screening and diagnosing patients with IACS.
我们的研究评估了高血压性视网膜病变、血脂异常和颈内动脉狭窄（ICAS）患者的颈内动脉狭窄与视网膜微血管变化之间的相关性。我们分析了光学相干断层扫描血管造影（OCTA）和颈动脉多普勒超声（US）提供的血管测量数据，并将OCTA参数与同侧颈动脉超声测量结果相关联。评估了三组（无狭窄、轻度狭窄和中度狭窄）在OCTA分析中的统计学差异，并将其与颈动脉多普勒参数相关联。我们的研究旨在评估OCTA是否可作为诊断为轻度和中度ICAS患者的筛查方法，以提高颈动脉变化的早期检测率，从而潜在降低ICAS的心血管和脑部并发症发生率。
我们对患有ICAS的高血压患者进行了一项研究，在分析视网膜血管系统以及三条颈动脉和椎动脉（VA）的颈动脉多普勒超声速度时使用了六个OCTA参数。采用Kruskal-Wallis和Dunn事后检验来确定正常、轻度和中度狭窄组之间是否存在统计学显著差异。使用Spearman和Pearson相关性分析来获得OCTA参数之间的相关性，如黄斑无血管区（FAZ）、非血流区（NFA）、血管血流区（VFA）以及颈动脉多普勒超声上的血流速度。
在最终分析中，纳入了49例患者，并获得了3组狭窄情况，包括21例无狭窄受试者、19例轻度狭窄受试者和9例中度狭窄受试者。形成了右眼组和左眼组。在患有右侧ICAS的右眼组中，当比较正常狭窄组与轻度狭窄组（P = 0.025）以及轻度狭窄组与中度狭窄组（P = 0.006）时，我们发现FAZ圆形度有统计学显著结果。在比较正常狭窄组与中度狭窄组（P = 0.004）以及轻度狭窄组与中度狭窄组（P = 0.011）时，NFA也有统计学显著结果。当比较正常组和中度组的FAZ面积（P = 0.016）和VFA（P = 0.037）时，获得了统计学显著值。在左眼方面，当比较正常和中度狭窄组时，我们发现VFA（P = 0.041）、NFA（P = 0.045）和VFA（P = 0.029）有统计学显著结果。当比较轻度和中度颈动脉狭窄组时，我们发现NFA（P = 0.001）、FAZ面积（P = 0.007）和VFA（P = 0.013）有统计学显著结果。在右眼组中，发现颈内动脉（ICA）收缩期峰值速度（PSV）与VFA（rho = -0.286）、ICA舒张末期速度（EDV）与NFA（r = 0.365）、颈外动脉（ECA）PSV与VFA（r = -0.288；rho = -0.317）、颈总动脉（CCA）PSV与NFA（rho = -0.345）、CCA EDV与NFA（rho = -0.292）以及VA PSV与VFA（r = -0.327；rho = -0.37）之间存在相关性。在分析OCTA参数时，我们发现NFA和VFA有统计学显著结果（r = -0.374；rho = -0.288）。在左眼组中也发现了相关性，包括ICA PSV与NFA（r = -0.351；rho = -0.313）、ICA EDV与VFA（r = -0.421；rho = -0.314）、ECA PSV与NFA（r = -0.412；rho = -0.45）、CCA PSV与NFA（P = -0.288；rho = -0.339）以及CCA EDV与NFA（r = -0.404；rho = -0.417）。
我们的研究发现颈动脉多普勒速度与OCTA血管血流参数之间存在相关性；因此，OCTA可作为监测与颈动脉狭窄相关的微血管变化的工具。OCTA可以提供有关患者整体血管状况的见解，因为它提供了关于血管密度和血流的主观数据；因此，通过同时使用OCTA和颈动脉多普勒超声监测高血压患者，我们可能能够提高筛查和诊断IACS患者的效率。
