Long-term Impact of Carotid Endarterectomy on Choroidal and Choriocapillaris Perfusion: The INFLATE Study
Purpose: When performed for clinically significant carotid artery stenosis (CAS), the long-term impact of carotid endarterectomy (CEA) on choroidal and choriocapillaris (CC) circulation was studied using swept-source OCT angiography. Design: Prospective observational study. Participants: Patients wi...
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Elsevier
2025-03-01
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| Series: | Ophthalmology Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666914524001878 |
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| author | Alessandro Berni, MD Yi Zhang, PhD Sandy Zhou Wenting, MD Natalie Noam, MD David Rabinovitch, BSc Basheer Sheick Yousif, MD Gissel Herrera, MD Mengxi Shen, MD, PhD Robert O’Brien, PhD Giovanni Gregori, PhD Ruikang K. Wang, PhD Philip J. Rosenfeld, MD, PhD Omer Trivizki, MD |
| author_facet | Alessandro Berni, MD Yi Zhang, PhD Sandy Zhou Wenting, MD Natalie Noam, MD David Rabinovitch, BSc Basheer Sheick Yousif, MD Gissel Herrera, MD Mengxi Shen, MD, PhD Robert O’Brien, PhD Giovanni Gregori, PhD Ruikang K. Wang, PhD Philip J. Rosenfeld, MD, PhD Omer Trivizki, MD |
| author_sort | Alessandro Berni, MD |
| collection | DOAJ |
| description | Purpose: When performed for clinically significant carotid artery stenosis (CAS), the long-term impact of carotid endarterectomy (CEA) on choroidal and choriocapillaris (CC) circulation was studied using swept-source OCT angiography. Design: Prospective observational study. Participants: Patients with clinically significant CAS undergoing unilateral CEA. Methods: Swept-source OCT angiography scans were performed on both eyes at baseline (before CEA), within 1 week post-CEA (short-term follow-up [FU]), and ≥30 days post-CEA (long-term FU). Using validated algorithms, we measured mean choroidal thickness (MCT), choroidal vascularity index (CVI), choroidal vessel volume (CVV), CC flow deficit percentage (CC FD%), and CC thickness within the 5-mm circle centered on the fovea for both the eye ipsilateral to CEA (surgical side) and the contralateral eye (nonsurgical side). Multivariable regression analysis was conducted to evaluate the impact of baseline demographic and clinical factors on the changes in choroidal and CC parameters. Main Outcome Measures: Both the short- and long-term changes in MCT, CVI, CVV, CC FD%, and CC thickness. Results: The study included 58 eyes from 29 patients. Significant short-term improvements in MCT (P < 0.001) and CC thickness (P = 0.006) were observed post-CEA on the surgical side. Long-term FU showed sustained increases in MCT compared with baseline (P = 0.02), while CC thickness was not significantly different from baseline (P = 0.10). The CVI did not change significantly from baseline at either short-term (P = 0.45) or long-term (P = 0.22) FU on the surgical side. While CVV demonstrated a short-term rise immediately post-CEA (P < 0.001), the difference was not statistically significant at the long-term evaluation (P = 0.06). No significant improvement in CC FD% from baseline was observed at any visit post-CEA (short-term P = 0.81, long-term P = 0.91). The nonsurgical side only showed a significant reduction in CVI at the long-term FU visit compared with before CEA (P = 0.01). Clinical variables such as age, degree of stenosis, diabetes, hypertension, and smoking status did not greatly impact the outcomes. Conclusions: Unilateral CEA demonstrated a sustained increase in MCT, suggesting persistent improvements in choroidal perfusion in the ipsilateral eye. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. |
| format | Article |
| id | doaj-art-f3a6e5ebea074ff4964339468484b3a8 |
| institution | Kabale University |
| issn | 2666-9145 |
| language | English |
| publishDate | 2025-03-01 |
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| series | Ophthalmology Science |
| spelling | doaj-art-f3a6e5ebea074ff4964339468484b3a82025-01-04T04:57:16ZengElsevierOphthalmology Science2666-91452025-03-0152100651Long-term Impact of Carotid Endarterectomy on Choroidal and Choriocapillaris Perfusion: The INFLATE StudyAlessandro Berni, MD0Yi Zhang, PhD1Sandy Zhou Wenting, MD2Natalie Noam, MD3David Rabinovitch, BSc4Basheer Sheick Yousif, MD5Gissel Herrera, MD6Mengxi Shen, MD, PhD7Robert O’Brien, PhD8Giovanni Gregori, PhD9Ruikang K. Wang, PhD10Philip J. Rosenfeld, MD, PhD11Omer Trivizki, MD12Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Bioengineering, University of Washington, Seattle, WashingtonDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Department of Ophthalmology, Tan Tock Seng Hospital, National Health Group Eye Institute, Singapore, Republic of SingaporeDepartment of Vascular Surgery, Tel Aviv Medical Center, University of Tel Aviv, Tel Aviv, IsraelDepartment of Ophthalmology, Tel Aviv Medical Center, University of Tel Aviv, Tel Aviv, IsraelDepartment of Vascular Surgery, Tel Aviv Medical Center, University of Tel Aviv, Tel Aviv, IsraelDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FloridaDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FloridaDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FloridaDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FloridaDepartment of Bioengineering, University of Washington, Seattle, Washington; Department of Ophthalmology, University of Washington, Seattle, WashingtonDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FloridaDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Department of Ophthalmology, Tel Aviv Medical Center, University of Tel Aviv, Tel Aviv, Israel; Correspondence: Omer Trivizki, MD, Department of Ophthalmology, Tel Aviv Medical Center, Waizman 6, Tel Aviv 6423906, Israel.Purpose: When performed for clinically significant carotid artery stenosis (CAS), the long-term impact of carotid endarterectomy (CEA) on choroidal and choriocapillaris (CC) circulation was studied using swept-source OCT angiography. Design: Prospective observational study. Participants: Patients with clinically significant CAS undergoing unilateral CEA. Methods: Swept-source OCT angiography scans were performed on both eyes at baseline (before CEA), within 1 week post-CEA (short-term follow-up [FU]), and ≥30 days post-CEA (long-term FU). Using validated algorithms, we measured mean choroidal thickness (MCT), choroidal vascularity index (CVI), choroidal vessel volume (CVV), CC flow deficit percentage (CC FD%), and CC thickness within the 5-mm circle centered on the fovea for both the eye ipsilateral to CEA (surgical side) and the contralateral eye (nonsurgical side). Multivariable regression analysis was conducted to evaluate the impact of baseline demographic and clinical factors on the changes in choroidal and CC parameters. Main Outcome Measures: Both the short- and long-term changes in MCT, CVI, CVV, CC FD%, and CC thickness. Results: The study included 58 eyes from 29 patients. Significant short-term improvements in MCT (P < 0.001) and CC thickness (P = 0.006) were observed post-CEA on the surgical side. Long-term FU showed sustained increases in MCT compared with baseline (P = 0.02), while CC thickness was not significantly different from baseline (P = 0.10). The CVI did not change significantly from baseline at either short-term (P = 0.45) or long-term (P = 0.22) FU on the surgical side. While CVV demonstrated a short-term rise immediately post-CEA (P < 0.001), the difference was not statistically significant at the long-term evaluation (P = 0.06). No significant improvement in CC FD% from baseline was observed at any visit post-CEA (short-term P = 0.81, long-term P = 0.91). The nonsurgical side only showed a significant reduction in CVI at the long-term FU visit compared with before CEA (P = 0.01). Clinical variables such as age, degree of stenosis, diabetes, hypertension, and smoking status did not greatly impact the outcomes. Conclusions: Unilateral CEA demonstrated a sustained increase in MCT, suggesting persistent improvements in choroidal perfusion in the ipsilateral eye. 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/S2666914524001878Carotid artery endarterectomy (CEA)Choriocapillaris flow deficits (CC FD)Choriocapillaris thicknessChoroidal vascular index (CVI)Mean choroidal thickness (MCT) |
| spellingShingle | Alessandro Berni, MD Yi Zhang, PhD Sandy Zhou Wenting, MD Natalie Noam, MD David Rabinovitch, BSc Basheer Sheick Yousif, MD Gissel Herrera, MD Mengxi Shen, MD, PhD Robert O’Brien, PhD Giovanni Gregori, PhD Ruikang K. Wang, PhD Philip J. Rosenfeld, MD, PhD Omer Trivizki, MD Long-term Impact of Carotid Endarterectomy on Choroidal and Choriocapillaris Perfusion: The INFLATE Study Ophthalmology Science Carotid artery endarterectomy (CEA) Choriocapillaris flow deficits (CC FD) Choriocapillaris thickness Choroidal vascular index (CVI) Mean choroidal thickness (MCT) |
| title | Long-term Impact of Carotid Endarterectomy on Choroidal and Choriocapillaris Perfusion: The INFLATE Study |
| title_full | Long-term Impact of Carotid Endarterectomy on Choroidal and Choriocapillaris Perfusion: The INFLATE Study |
| title_fullStr | Long-term Impact of Carotid Endarterectomy on Choroidal and Choriocapillaris Perfusion: The INFLATE Study |
| title_full_unstemmed | Long-term Impact of Carotid Endarterectomy on Choroidal and Choriocapillaris Perfusion: The INFLATE Study |
| title_short | Long-term Impact of Carotid Endarterectomy on Choroidal and Choriocapillaris Perfusion: The INFLATE Study |
| title_sort | long term impact of carotid endarterectomy on choroidal and choriocapillaris perfusion the inflate study |
| topic | Carotid artery endarterectomy (CEA) Choriocapillaris flow deficits (CC FD) Choriocapillaris thickness Choroidal vascular index (CVI) Mean choroidal thickness (MCT) |
| url | http://www.sciencedirect.com/science/article/pii/S2666914524001878 |
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