Investigation of Retinal Microcirculation Alterations Following Carotid Artery Angioplasty and Stenting Using Optical Coherence Tomography Angiography (OCTA)

Zehui Shi ¹ Chunqiong Dong ¹ Hanfei Tang ^2,3 Daqiao Guo ^2,3 Xianglian Li ¹ Bing Xie ⁴ Xiao Tang ^2,3 Xiuping Chen ^1*

• ¹ Depatment of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China
• ² Department of Vascular Surgery,Zhongshan Hospital, Fudan University, shanghai, China
• ³ Institute of Vascular Surgery, Fudan University, Shang hai, China
• ⁴ Department of Ophthalmology, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shang hai, China

Background: Carotid artery stenosis (CAS) is a common vascular condition that can impair retinal and optic nerve blood supply, leading to ocular ischemic damage. Optical coherence tomography angiography (OCTA) provides a non-invasive method to evaluate retinal microcirculation and detect vascular changes in CAS patients.Methods: This study utilized OCTA to evaluate changes in retinal microcirculation in CAS patients before and after carotid artery stenting. A 6×6 mm OCTA scan was performed to analyze deep retinal vascular complex (DVC) blood flow density, foveal avascular zone area (FAZA), foveal density within a 300 μm-wide ring surrounding the FAZ (FD-300), and radial peripapillary capillary vessel density (RPC-VD). Additionally, ultra-wide-field OCTA imaging (24×20 mm) was employed to comprehensively assess perfusion in both the posterior pole and peripheral retina.Results: Following carotid artery stenting, significant improvements were observed in the ipsilateral eye, including increased macular blood flow density (P = 0.004), FD-300 (P = 0.031), RPC-VD (P = 0.028) and decreased FAZA (P = 0.018) in the deep retinal vascular layer, indicating enhanced retinal microcirculation. No statistically significant changes were found in the contralateral eye. In some cases, ultra-wide-field OCTA revealed a reduction in macular non-perfusion areas in the ipsilateral eye, alongside an increase in non-perfusion areas near the vascular arcades.删除了: FAZA (P = 0.018),删除了: and Conclusions: Carotid artery stenting effectively improves retinal microcirculation in CAS patients, as evidenced by increased blood flow density and reduced non-perfusion areas in the ipsilateral eye. OCTA is a valuable non-invasive tool for assessing retinal circulation dynamics, identifying microvascular abnormalities, and monitoring treatment efficacy in CAS patients.