Abstract
To evaluated the changes in choroidal vasculature in patients with ocular ischemic syndrome (OIS) and in the ipsilateral eyes of patients with symptomatic carotid artery stenosis (CAS). A total of 50 patients (15 patients with OIS, 10 patients with symptomatic CAS, 25 patients of age-and sex-matched control group) were included, and the medical records were retrospectively reviewed. The mean subfoveal choroidal thickness (SFCT) of each eye was measured, and binary images of the choroid were evaluated to compare the mean choroidal area and the luminal area. The mean SFCT was 170.5±75.3 μm in the eyes with OIS, 154.8±62.9 μm in the ipsilateral eyes with symptomatic CAS, and 277.5±73.2 μm in the right eyes of the control group patients (P<0.001). The mean choroidal area was 494,478.6±181,846.2 μm2 in the eyes with OIS, 453,750.0±196,725.8 μm2 in the ipsilateral eyes with symptomatic CAS, and 720,520±281,319.5 μm2 in the control group eyes (P = 0.036). The mean luminal area was 333,185.7±112,665.9 μm2 in the eyes with OIS, 313,983.3±132,032.1 μm2 in the ipsilateral eyes with symptomatic CAS, and 480,325.0±185,112.6 μm2 in the control group eyes (P = 0.046). The mean SFCT, mean choroidal area, and mean luminal area were significantly smaller in the eyes with OIS (P = 0.017, P = 0.005, and P = 0.004, respectively), and those with symptomatic CAS (P = 0.020, P = 0.016, and P = 0.021, respectively) than in the unaffected contralateral eyes. There were no significant differences between the eyes in the control group (P = 0.984, P = 284, and P = 0.413, respectively). The mean SFCT, mean choroidal area, and mean luminal area were significantly thinner in the eyes with OIS and the ipsilateral eyes with symptomatic CAS, compared with the control group eyes. The eyes with OIS and those with symptomatic CAS had significantly thinner SFCT, and smaller choroidal area and luminal area than the unaffected contralateral eyes. Choroid may reflect the vascular status of the carotid artery, indicated by choroidal thinning and decreasing choroidal area, especially luminal area.
Highlights
The retina has a dual blood supply; the blood supply for the inner retina is derived from retinal vasculature and the outer retina is supplied solely by the choroidal vasculature [1]
The mean subfoveal choroidal thickness (SFCT), mean choroidal area, and mean luminal area were significantly smaller in the eyes with ocular ischemic syndrome (OIS) (P = 0.017, P = 0.005, and P = 0.004, respectively), and those with symptomatic carotid artery stenosis (CAS) (P = 0.020, P = 0.016, and P = 0.021, respectively) than in the unaffected contralateral eyes
There were no significant differences between the eyes in the control group (P = 0.984, P = 284, and P = 0.413, respectively)
Summary
The retina has a dual blood supply; the blood supply for the inner retina is derived from retinal vasculature and the outer retina is supplied solely by the choroidal vasculature [1]. To maintain the oxygen supply to the outer retina, especially to the photoreceptors, the choroid maintains a high blood flow [2]. This blood flow is the highest of any tissue in the body per unit tissue weight; it is nearly tenfold higher than the blood flow to the brain [2]. Stenosis or occlusion of the internal carotid artery (ICA) or the common carotid artery (CCA) may lead to impaired ocular blood circulation because the ophthalmic artery is the first intradural branch of the ICA. Ocular manifestations such transient monocular blindness or ocular arterial occlusive disease can sometimes precede the signs of cerebrovascular disease (e.g., ischemic stroke) [3,4,5,6,7,8]
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