The following is a summary of “Risk factors of internal carotid artery stenosis in patients with proliferative diabetic retinopathy: an analysis using optical coherence tomography and optical coherence tomography angiography,” published in the April 2024 issue of Ophthalmology by Lee al.
Researchers conducted a retrospective study investigating the correlation between internal carotid artery (ICA) stenosis (CAS) severity and retinal parameters in patients with proliferative diabetic retinopathy (PDR) to identify potential risk factors.
They involved 68 patients (136 eyes) diagnosed with bilateral PDR (January 1, 2017, to December 31, 2021). CAS was evaluated using neck computed tomography angiography (CTA) and carotid duplex ultrasound (CDUS), categorizing stenosis into two groups: regular (group 1) and mild or above (group 2), according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Optical coherence tomography (OCT) and OCT angiography (OCTA) assessed various retinal parameters, including subfoveal choroidal thickness (SFCT), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, vessel density (VD), and foveal avascular zone (FAZ) area. Statistical analyses established correlations between ICA degrees and retinal parameters.
The results showed notable discrepancies among groups in total VD, FAZ area, total RNFL thickness, and temporal RNFL thickness, revealing discernible retinal alterations in patients with more severe ICA stenosis. Additionally, significant variances were found in hyperlipidemia, total cholesterol levels, and intraocular pressure (IOP). SFCT, central VD, average GCIPL, and superior, nasal, and inferior RNFL thickness demonstrated no remarkable differences.
Investigators concluded that retinal changes, such as increased FAZ area, decreased total VD, and thinner temporal RNFL, in patients with PDR suggest a need for carotid artery evaluation.
Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03391-z