Decreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT Angiography

Objective: To investigate the short-term blood flow changes and image features of the retina and choroid in patients who underwent carotid artery revascularization (CAR) for severe carotid artery stenosis using widefield swept-source OCT angiography (OCTA). Design: Prospective study. Participants: T...

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Main Authors: Li Zhang, MD, Jia-Wei Liu, MD, Qing-Qing Tang, MD, Chun-Yan Lei, MD, Xue Lin, MD, Sheng Gao, MD, Tian-Yu Yang, BS, Fa-Yun Hu, MD, Mei-Xia Zhang, MD
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Language:English
Published: Elsevier 2025-03-01
Series:Ophthalmology Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666914524001908
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author Li Zhang, MD
Jia-Wei Liu, MD
Qing-Qing Tang, MD
Chun-Yan Lei, MD
Xue Lin, MD
Sheng Gao, MD
Tian-Yu Yang, BS
Fa-Yun Hu, MD
Mei-Xia Zhang, MD
author_facet Li Zhang, MD
Jia-Wei Liu, MD
Qing-Qing Tang, MD
Chun-Yan Lei, MD
Xue Lin, MD
Sheng Gao, MD
Tian-Yu Yang, BS
Fa-Yun Hu, MD
Mei-Xia Zhang, MD
author_sort Li Zhang, MD
collection DOAJ
description Objective: To investigate the short-term blood flow changes and image features of the retina and choroid in patients who underwent carotid artery revascularization (CAR) for severe carotid artery stenosis using widefield swept-source OCT angiography (OCTA). Design: Prospective study. Participants: This prospective study included 112 eyes (56 eyes on the ipsilateral side and 56 eyes on the contralateral side) of 56 participants with severe carotid artery stenosis. Methods: Participants were examined using widefield swept-source OCTA covering an area of 16 × 16 mm centered on the fovea before and after CAR. Retinal parameters including central macular thickness, vessel density of the retinal superficial vascular complex (VDRSVC), vessel density of the retinal deep vascular complex, and vessel density of the retina (VDR) and choroidal parameters, including central choroidal thickness (CCT), vessel density of the choriocapillaris (VDCC), vessel density of the medium and large choroidal vessels, choroidal vessel volume ratio (CVV/a), and 3-dimensional choroidal vascularity index (3D-CVI) were measured. Besides, preoperative and postoperative OCTA images were screened and compared. Main Outcome Measures: Retinal and choroidal parameters obtained from swept-source OCTA. Results: In the ipsilateral eye (56 eyes), an increase in VDRSVC, VDR, CVV/a, CCT, and 3D-CVI and a decrease in VDCC was found after CAR. Thirteen patients were identified with postoperative ipsilateral choriocapillaris flow voids (PICCFVs) with OCTA images, and the presence of PICCFVs was associated with greater postoperative VDCC decrease. In the contralateral eye (56 eyes), we found an increase in VDRSVC, vessel density of the retinal deep vascular complex, and VDR, whereas no difference in choroidal parameters after CAR and no findings of PICCFVs were found. Conclusions: The findings of this study suggest that ocular microvascular perfusion is improved after CAR in the ipsilateral eye and the contralateral eye within a wide field of the fundus. The VDCC is decreased in the ipsilateral eye, which may indicate infarctions of choriocapillaris or ischemia–reperfusion injury of the choriocapillaris after CAR. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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spelling doaj-art-e372b95affe84f1eafde3e810e30c55e2024-12-22T05:29:58ZengElsevierOphthalmology Science2666-91452025-03-0152100654Decreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT AngiographyLi Zhang, MD0Jia-Wei Liu, MD1Qing-Qing Tang, MD2Chun-Yan Lei, MD3Xue Lin, MD4Sheng Gao, MD5Tian-Yu Yang, BS6Fa-Yun Hu, MD7Mei-Xia Zhang, MD8Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan Province, ChinaDepartment of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan Province, ChinaDepartment of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan Province, ChinaDepartment of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan Province, ChinaDepartment of Neurology, Sichuan University West China Hospital, Chengdu, Sichuan Province, ChinaDepartment of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan Province, ChinaDepartment of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan Province, ChinaDepartment of Neurology, Sichuan University West China Hospital, Chengdu, Sichuan Province, China; Correspondence: Fa-Yun Hu, MD, Department of Neurology, Sichuan University West China Hospital, No. 37, Guoxue Lane, Chengdu, Sichuan Province, China 610041.Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan Province, China; Mei-Xia Zhang, MD, Department of Ophthalmology, Sichuan University West China Hospital, No. 37, Guoxue Lane, Chengdu, Sichuan Province, China, 610041.Objective: To investigate the short-term blood flow changes and image features of the retina and choroid in patients who underwent carotid artery revascularization (CAR) for severe carotid artery stenosis using widefield swept-source OCT angiography (OCTA). Design: Prospective study. Participants: This prospective study included 112 eyes (56 eyes on the ipsilateral side and 56 eyes on the contralateral side) of 56 participants with severe carotid artery stenosis. Methods: Participants were examined using widefield swept-source OCTA covering an area of 16 × 16 mm centered on the fovea before and after CAR. Retinal parameters including central macular thickness, vessel density of the retinal superficial vascular complex (VDRSVC), vessel density of the retinal deep vascular complex, and vessel density of the retina (VDR) and choroidal parameters, including central choroidal thickness (CCT), vessel density of the choriocapillaris (VDCC), vessel density of the medium and large choroidal vessels, choroidal vessel volume ratio (CVV/a), and 3-dimensional choroidal vascularity index (3D-CVI) were measured. Besides, preoperative and postoperative OCTA images were screened and compared. Main Outcome Measures: Retinal and choroidal parameters obtained from swept-source OCTA. Results: In the ipsilateral eye (56 eyes), an increase in VDRSVC, VDR, CVV/a, CCT, and 3D-CVI and a decrease in VDCC was found after CAR. Thirteen patients were identified with postoperative ipsilateral choriocapillaris flow voids (PICCFVs) with OCTA images, and the presence of PICCFVs was associated with greater postoperative VDCC decrease. In the contralateral eye (56 eyes), we found an increase in VDRSVC, vessel density of the retinal deep vascular complex, and VDR, whereas no difference in choroidal parameters after CAR and no findings of PICCFVs were found. Conclusions: The findings of this study suggest that ocular microvascular perfusion is improved after CAR in the ipsilateral eye and the contralateral eye within a wide field of the fundus. The VDCC is decreased in the ipsilateral eye, which may indicate infarctions of choriocapillaris or ischemia–reperfusion injury of the choriocapillaris after CAR. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.http://www.sciencedirect.com/science/article/pii/S2666914524001908Carotid artery stenosisCarotid artery revascularizationOptical coherence tomography angiographyRetinal microvasculature
spellingShingle Li Zhang, MD
Jia-Wei Liu, MD
Qing-Qing Tang, MD
Chun-Yan Lei, MD
Xue Lin, MD
Sheng Gao, MD
Tian-Yu Yang, BS
Fa-Yun Hu, MD
Mei-Xia Zhang, MD
Decreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT Angiography
Ophthalmology Science
Carotid artery stenosis
Carotid artery revascularization
Optical coherence tomography angiography
Retinal microvasculature
title Decreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT Angiography
title_full Decreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT Angiography
title_fullStr Decreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT Angiography
title_full_unstemmed Decreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT Angiography
title_short Decreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT Angiography
title_sort decreased choriocapillaris vessel density in the ipsilateral eye after carotid artery revascularization detected by widefield swept source oct angiography
topic Carotid artery stenosis
Carotid artery revascularization
Optical coherence tomography angiography
Retinal microvasculature
url http://www.sciencedirect.com/science/article/pii/S2666914524001908
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