Optical Coherence Tomography Angiography Evaluation of Retinal Microvasculature Before and After Carotid Angioplasty and Stenting

Chia-Wei Lee,An-Guor Wang,Hui-Chen Cheng,Feng-Chi Chang

doi:10.1038/s41598-019-51382-8

Abstract

The aim of the study was to evaluate the influence of carotid angioplasty and stenting (CAS) on retinal microvasculature using optical coherence tomography angiography (OCTA) in patients with severe carotid stenosis. 20 patients with severe carotid stenosis underwent comprehensive ophthalmic examinations and OCTA before and one month after CAS. Automated algorithms were used to quantify vessel density in the macular superficial vascular complex (SVC), deep vascular complex (DVC), and radial peripapillary capillary (RPC) around the optic disc. Eyes on the operated side constituted the ipsilateral eye group, and the other eye constituted the fellow eye group. In the ipsilateral eye group, the vessel density in the DVC increased significantly after stent implantation (P = 0.010), but the vessel density change in the SVC was not statistically different (P = 0.999). In the fellow eye group, the vessel density in the SVC (P = 0.028) and DVC (P = 0.034) were significantly increased after stent implantation. The vessel density in the RPC did not significantly change in the ipsilateral (P = 0.363) or fellow (P = 0.878) eye groups. This study shows that unilateral CAS for severe carotid stenosis increases macular vessel densities in both eyes.

Highlights

The emergence of optical coherence tomography angiography (OCTA) revolutionized the way of visualizing and quantifying retinal microvasculature
We investigated short-term retinal microvasculature changes in patients with severe carotid stenosis following carotid angioplasty and stenting (CAS)
BCVA = best-corrected visual acuity; MAR = minimum angle of resolution; MD = mean deviation; VD = vessel density; SVC = superficial vascular complex; DVC = deep vascular complex; radial peripapillary capillary (RPC) = radial peripapillary capillaries All values are presented as the mean ± standard deviation. *P values are based on the Wilcoxon signed-rank test. †Statistically significant

Summary

Introduction

The emergence of optical coherence tomography angiography (OCTA) revolutionized the way of visualizing and quantifying retinal microvasculature. OCTA is a novel, non-invasive imaging modality that generates vascular flow maps across the retina and choroid, thereby constructing a three-dimensional image of the retinal vasculature. Several studies have shown that OCTA can be a reliable tool for the qualitative and quantitative assessments of the retinal, choroidal, or optic nerve vessels during various ocular pathological or physiological changes[10,11,12]. Recent studies have demonstrated the ability of OCTA to quantify retinal microvascular changes in monitoring cardiovascular risk[13,14]. The present study used OCTA to quantify the microcirculation of the retina and optic nerve head. The aim was to investigate the influence of CAS on the retinal and peripapillary vascular plexuses in patients with severe carotid stenosis

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