Abstract
Purpose :
A growing body of research indicates that abnormal retinal microvascular features may serve as a novel biomarker reflecting the severity of underlying cardiovascular, neurodegenerative, and microvascular disease. Since blood flow to the retina is predominantly supplied by the internal carotid artery, we hypothesized that retinal microvasculature may change after carotid endarterectomy reflecting the disease status or therapeutic effects in patients with severe carotid stenosis.
Methods :
Nine patients with carotid artery stenosis >70% underwent complete ophthalmic examinations and Optical Coherence Tomography Angiography (OCTA, Spectralis, Heidelberg) before carotid endarterectomy and 48 hours (h) and 3 months post-surgery. Image J software (National Institutes of Health, Bethesda, MD) was used to analyze OCTA images. Non-local means denoising filter, Phansalkar as adptative local thresholding methods and binarization algorisms were used to process the images. Eyes on the operated side constituted the ipsilateral eye group, and the other eye constituted the fellow eye group.
Results :
: 8 male and 7 female were included, with a mean age of 73 years old.
In the ipsilateral eye group, FAZ area reduced significantly after endarterectomy (before vs 48h after surgery, p=0,012; before vs 3 months after surgery, p=0,012). FAZ area also decreases from 48h post-surgery to 3 months after surgery; however, this difference is not statistically significant (p=0,41). No differences in FAZ area were found in the fellow eye during follow-up (p=0,095).
Regarding vessel densities (VD), no statistical differences were found in the ipsilateral eye in macular or papillary scans both in superficial (SCP) and deep capillary plexus (DCP) (p<0.05), although a tendency for an increase in VD is evident in SCP of macula centered scans.
Similarly, no differences in vessel density were found during the follow-up in the fellow eye.
Conclusions :
Endarterectomy for severe carotid stenosis reduce FAZ area in the immediate and midterm post-surgery.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.