RETINAL ISCHEMIC PERIVASCULAR LESIONS ARE ASSOCIATED WITH INCREASED CAROTID ARTERY STENOTIC DEGREE

Purpose: Retinal ischemic perivascular lesions (RIPLs) have been reported as potential biomarkers for cardiovascular diseases and stroke. The authors aimed to investigate the RIPLs in patients with carotid artery stenosis (CAS) and their association with stenotic degree. Methods: Patients with unilateral CAS or carotid artery occlusion were recruited. Optical coherence tomography was conducted for assessing the presence, number, and distribution of RIPLs. Optical coherence tomography angiography was used for evaluating microvascular density in superficial vascular complex and deep vascular complex. Results: Eight hundred and fifty-four eyes from 474 patients with CAS were included. Ipsilateral eyes had more PRILs compared with contralateral eyes (all P < 0.01). Patients with CAS with cerebral infarction had a higher incidence and broader distribution of RIPLs compared with those without infarction (both P < 0.05). The presence, number, and distribution of RIPLs were positively associated with stenotic degree (all P < 0.001). Eyes with RIPLs had lower superficial vascular complex density ( P = 0.020) compared with eyes without RIPLs. Conclusion: Retinal ischemic perivascular lesions are anatomical markers of ischemia and are suggested to be associated with cerebral infarction and stenotic degree in patients with CAS. Optical coherence tomography/optical coherence tomography angiography is a noninvasive tool to detect retinal ischemic changes and quantitatively measure retinal microvascular changes in patients with CAS.