Choroidal vascular changes in internal carotid artery stenosis: a retrospective cohort study in Chinese population

Abstract

BackgroundTo evaluate choroidal vascularity index (CVI) in eyes with internal carotid artery (ICA) stenosis using binarization tool in enhanced depth images scanned by spectral domain optical coherence tomography.MethodsA retrospective cohort study was conducted in 142 patients with ICA stenosis, and 20 normal control subjects matched with the age, sex, etc. According to the diagnostic criteria, the participants are divided into a normal control group (20 cases), a mild stenosis group (64 cases), a moderate stenosis group (61 cases), and a severe stenosis group (17 cases). Enhanced depth imaging optical coherence tomography (EDIOCT) was performed to scan macular fovea, which was separated into a luminal area and a stromal area using image binarization. The choroidal vascularity index (CVI) is luminal area divided by total choroidal area.ResultsThere was no statistical difference in age or sex among groups. Subfoveal choroidal thickness (SFCT) in the severe stenosis group was significantly lower than that in the normal group (P < 0.05). Moreover, the CVI in moderate stenosis group and severe stenosis group were significantly lower compared with the normal control group (P < 0.001). When CVI = 65.16% was set as the cut-off value, all 162 subjects could be divided into two groups, CVI ≤ 65.16 (n = 83) and CVI > 65.16% (n = 79). The proportions of mild stenosis, moderate stenosis, and severe stenosis in CVI ≤ 65 .16 group and CVI > 65.16% group were statistically significant (P < 0.001).ConclusionCVI may be a useful indicator for early diagnosis and monitoring of choroidal vascular changes in ICA stenosis.

Subfoveal choroidal thickness in ipsi‐ and contralateral eyes of patients with carotid stenosis before and after carotid endarterectomy: a prospective study

“…In concordance with recent findings (Sayin et al 2015; Kang et al 2019; Li et al 2019) we found thinner SFCT in patients with CS compared to that of control subjects (Fig. 1).…”

Optical Coherence Tomography Angiography as a Noninvasive Assessment of Cerebral Microcirculatory Disorders Caused by Carotid Artery Stenosis

“…Therefore, retinal microvascular abnormalities are considered to reflect the degree of cerebral microvascular disease [7]. Several studies [8][9][10][11] have confirmed that ocular manifestations can reflect the changes of carotid vessels; however, the potential of previously employed examination methods is limited. For example, a risk of allergy to contrast media exists in retinal angiography [12].…”

“…For example, a risk of allergy to contrast media exists in retinal angiography [12]. Moreover, other methods, such as retinal thickness [11] and fundus photography [10], do not possess adequate accuracy for the observation of tiny blood vessels. Optical coherence tomography angiography (OCTA) is a new technology that provides high-resolution retinal vascular images suitable for direct observation of 5 μm capillaries.…”

Heart, Eye, and Artificial Intelligence: A Review

“…The use of deep learning combined with retinal imaging in the diagnosis of cardiovascular conditions is a relatively new area of research (Table 1 [23][24][25][26][27][28][29][30][31]). In 2007, researchers from Australia, Singapore, and the USA showed that retinopathies obtained from fundus photographs were associated with the presence of any degree of coronary artery calcification (CAC) score > 0, measured by cardiac computed tomography scanning (odds ratio (OR): 1.22; 95% CI: 1.04 -1.43) in a multi-ethnic population without clinical heart disease, after adjustment for multiple variables [23].…”

“…However, in patients with severe internal carotid artery stenosis, SFCT was significantly lower. Those with severe stenosis also had a lower choroidal vascularity index (CVI), illustrating that CVI may be an indicator of stenotic changes in the internal carotid artery [ 27 ].…”