EVALUATION OF MACULAR FLOW VOIDS ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AS POTENTIAL BIOMARKERS FOR SILENT CEREBRAL INFARCTION IN SICKLE CELL DISEASE

EVALUATION OF RETINAL CAPILLARY DENSITY USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY ACCORDING TO ACUTE ISCHEMIC STROKE ETIOLOGIES: A Matched Case-Control Study Stroke and Retinal Capillary Density

PURPOSE

To investigate retinal microvascular changes in ischemic stroke patients using optical coherence tomography angiography (OCT-A) and assess these alterations based on stroke etiology.

METHODS

Case-control study conducted at Montpellier University Hospital from May 2021 to March 2022 (Institutional Review Board: 202000607). Retinal vascular features were compared between strokes patients and age-matched and sex-matched controls. Optical coherence tomography angiography was performed using RTVue-XR-Avanti with AngioVue (Optovue). Multivariate mixed-effects analysis of covariance models adjusted for age, sex, intraocular pressure, and cardiovascular risk factors were used.

RESULTS

Ninety-two eyes were included: 21 with micro-/macroangiopathy stroke, 12 with etiologically ambiguous stroke, 13 with cardioembolic stroke, and 46 eyes from control subjects. After adjusting for age, sex, and intraocular pressure, stroke patients had significantly lower parafoveal superficial capillary plexus vessel density ( P = 0.013) and superficial capillary plexus flow index ( P = 0.023) compared with control subjects, especially in the macro-/microangiopathy subgroup. When cardiovascular risk factors were included, only the superficial capillary plexus flow index difference remained significant ( P = 0.023). Optical coherence tomography angiography's diagnostic accuracy was validated with an area under the receiver operating characteristic curve of 0.83.

CONCLUSION

Optical coherence tomography angiography effectively detects retinal microvascular alterations in stroke patients, with persistent alterations in macro-/microangiopathy strokes after adjusting for cardiovascular risk factors. These findings support OCT-A's role in stroke subtype classification.

Association Between Retinal Microvascular Metrics Using Optical Coherence Tomography Angiography and Carotid Artery Stenosis in a Chinese Cohort

Objectives: The main aim was to investigate the association between retinal microvascular metrics using optical coherence tomography angiography (OCTA) and carotid artery stenosis (CAS) in an aging Chinese cohort.

Methods: In this cross-sectional and observational study, 138 eyes of 138 participants were examined. Indices of the microcirculation measured by OCTA included mean vessel density (VD), skeleton density (SD), vessel diameter index (VDI), fractal dimension (FD) and foveal avascular zone (FAZ) of the superficial retinal layer (SRL) and deep retinal layer (DRL), and peripapillary vessel caliber. The correlation of these indices with the carotid atherosclerotic lesions including carotid intima media thickness (CIMT) and common carotid artery (CCA) plaque was assessed.

Results: A total of 72 of 138 eyes demonstrated an increased (≥1 mm) CIMT, and 32 of the eyes presented common carotid plaques. Macular VD, SD, and FD were decreased with the increasing CCA caliber diameter (p < 0.05, respectively). Superficial and deep macular FDs were negatively associated with CIMT as well as the existence of CCA plaques (p < 0.05, respectively).

Conclusion: Changes in retinal microvasculature accessed by OCTA may be used as one of the non-invasive early indicators to monitor asymptomatic CAS.