Xanthou Foteini, Dastiridou Anna, Giannoukas Athanasios, Matsagkas Miltiadis, Tzavara Chara, Chaidoulis Athanasios, Androudi Sofia, Tsironi Evangelia E
Ophthalmology Department, Faculty of Medicine, School of Health Sciences, University of Thessaly, University Hospital of Larissa, 41110 Larissa, Greece.
Vascular Surgery Department, Faculty of Medicine, School of Health Sciences, University of Thessaly, University Hospital of Larissa, 41110 Larissa, Greece.
Diagnostics (Basel). 2025 Jul 21;15(14):1826. doi: 10.3390/diagnostics15141826.
: This study aimed to prospectively assess the incidence of retinal embolization and to evaluate the vascular and structural changes in the retina and choroid in 52 patients with asymptomatic severe carotid artery disease who underwent carotid artery revascularization. : In our study, 35 patients underwent carotid endarterectomy (CEA) and 17 underwent carotid artery stenting (CAS). Biomicroscopy, fundoscopy, optical coherence tomography (OCT), and OCT-angiography (OCTA) were performed at baseline and 1 month after revascularization. : The subfoveal choroidal thickness (SFCT), peripapillary choroidal thickness inferior to the optic nerve head (ppCTi), total overall average retinal vascular density (rVDtot), and total overall average choriocapillaris vascular density (ccVDtot) of the eyes ipsilateral to the operated carotid artery increased significantly after revascularization, whereas a statistically significant increase was also found in the SFCT, rVDtot, and ccVDtot of the contralateral eyes in the overall cohort. Comparing the two study groups, we found that the SFCT, superior and inferior peripapillary choroidal thicknesses (ppCTs, ppCTi), rVDtot, and ccVDtot increased in both groups after revascularization, but significantly only in the CEA group. Furthermore, the temporal choriocapillaris vascular density (ccVDt) increased significantly after revascularization in both groups to a similar degree. : Carotid artery revascularization led to a statistically significant increase in retinal and choroidal vascular densities, which indicates significantly improved ocular perfusion. The analysis of the findings of the two study groups suggests the superiority of CEA in terms of improving ocular perfusion in asymptomatic severe carotid artery disease. The rate of retinal embolization was similar in both surgical groups.
本研究旨在前瞻性评估视网膜栓塞的发生率，并评估52例无症状重度颈动脉疾病患者接受颈动脉血运重建术后视网膜和脉络膜的血管及结构变化。在我们的研究中，35例患者接受了颈动脉内膜切除术（CEA），17例接受了颈动脉支架置入术（CAS）。在基线和血运重建术后1个月进行生物显微镜检查、眼底镜检查、光学相干断层扫描（OCT）和OCT血管造影（OCTA）。手术侧颈动脉同侧眼睛的黄斑下脉络膜厚度（SFCT）、视神经乳头下方的视乳头周围脉络膜厚度（ppCTi）、总的视网膜血管密度（rVDtot）和总的脉络膜毛细血管血管密度（ccVDtot）在血运重建术后显著增加，而在整个队列中，对侧眼睛的SFCT、rVDtot和ccVDtot也有统计学意义的增加。比较两个研究组，我们发现血运重建术后两组的SFCT、视乳头周围脉络膜上下厚度（ppCTs、ppCTi）、rVDtot和ccVDtot均增加，但仅在CEA组有显著增加。此外，两组血运重建术后颞侧脉络膜毛细血管血管密度（ccVDt）均有显著增加，且程度相似。颈动脉血运重建导致视网膜和脉络膜血管密度有统计学意义的增加，这表明眼部灌注显著改善。对两个研究组结果的分析表明，在改善无症状重度颈动脉疾病患者的眼部灌注方面，CEA具有优势。两个手术组的视网膜栓塞发生率相似。
