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

Shuang Li,Yanling Wang,Xuqiang Lang,Wei Wang,Yang Yang,Hongyang Li,Jingjing Wang,Kang Wang

doi:10.1186/s12886-019-1218-7

Shuang Li, Yanling Wang + Show 6 more

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https://doi.org/10.1186/s12886-019-1218-7

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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.

Highlights

To 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
About 5% of patients with severe ICA stenosis develop ocular hemodynamic abnormalities that can lead to neovascular glaucoma, optic atrophy, and even permanent blindness
A total of 179 patients diagnosed with ICA stenosis/obstruction were enrolled and divided into four groups according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria [20]: a non-stenosis group, a mild stenosis group, a moderate stenosis group, and a severe stenosis group

Summary

Introduction

To 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. Internal carotid artery (ICA) stenosis or obstruction may lead to severe ischemic cerebrovascular disease, and is an important cause of ischemic eye disease, which affects the patient’s vision, but even causes physical disability and sudden death. About 5% of patients with severe ICA stenosis develop ocular hemodynamic abnormalities that can lead to neovascular glaucoma, optic atrophy, and even permanent blindness. 7.5 out of every 1 million people develop ocular ischemic syndrome [3] This proportion may be underestimated because the correlation between ocular manifestations and carotid stenosis is often not noticed by doctors and patients [4, 5]. Choroidal blood flow is likely to be the first sensitive indicator of blood flow change [6]

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