Metrics of retinal vasculature detected on OCTA in carotid artery stenosis: A systematic review and meta-analysis

Background: Carotid artery stenosis (CAS) is a major cause of cerebral microcirculation dysfunction, contributing to 15–20% of ischemic strokes. Retinal vessel changes is associated with several systemic diseases, including CAS. This systematic review investigates retinal microvascular alterations m...

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Main Authors: Kaibao Ji, Yang Yang, Yiqiao Xing, Wei Wan
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Photodiagnosis and Photodynamic Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S1572100024004277
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author Kaibao Ji
Yang Yang
Yiqiao Xing
Wei Wan
author_facet Kaibao Ji
Yang Yang
Yiqiao Xing
Wei Wan
author_sort Kaibao Ji
collection DOAJ
description Background: Carotid artery stenosis (CAS) is a major cause of cerebral microcirculation dysfunction, contributing to 15–20% of ischemic strokes. Retinal vessel changes is associated with several systemic diseases, including CAS. This systematic review investigates retinal microvascular alterations measured using optical coherence tomography angiography (OCTA) in patients with CAS. Methods: We comprehensively searched the electronic databases, namely PubMed, Cochrane Library, Embase, and Web of Science. Macular and optic nerve head vascular density (VD) in patients with CAS were compared to controls. Pooled data for each outcome were calculated as standardized mean difference (SMD) and 95% confidence interval. OCTA parameters were analyzed using Review Manager Version 5.4.1 software. Results: Seven articles were included in this meta-analysis. Whole macular enface superficial and deep VD were significantly lower in patients with CAS than in controls (SMD = -0.97, P = 0.002; SMD = -1.05, P = 0.006, respectively). Additionally, the parafoveal superficial VD was significantly lower in the CAS group than in the healthy group (SMD = -0.71, P= 0.001). Radial peripapillary capillary (RPC) whole-image VD (SMD = -0.90, P< 0.0001), RPC inside disc VD (SMD = -0.49, P = 0.02), and RPC peripapillary VD (SMD = -0.64, P = 0.0003) were also significantly lower in patients with CAS compared to healthy individuals. Conclusion: These findings suggest that patients with CAS are prone to decreased VD in the macular and optic nerve head areas. Hence, OCTA shows potential as a promising tool for the early detection of cerebral microcirculation disorders due to CAS.
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spelling doaj-art-97cb9510f41048fd89af171e7c0d7dab2025-08-20T01:59:30ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002024-12-015010439010.1016/j.pdpdt.2024.104390Metrics of retinal vasculature detected on OCTA in carotid artery stenosis: A systematic review and meta-analysisKaibao Ji0Yang Yang1Yiqiao Xing2Wei Wan3Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, ChinaDepartment of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, ChinaDepartment of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, ChinaCorresponding author.; Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, ChinaBackground: Carotid artery stenosis (CAS) is a major cause of cerebral microcirculation dysfunction, contributing to 15–20% of ischemic strokes. Retinal vessel changes is associated with several systemic diseases, including CAS. This systematic review investigates retinal microvascular alterations measured using optical coherence tomography angiography (OCTA) in patients with CAS. Methods: We comprehensively searched the electronic databases, namely PubMed, Cochrane Library, Embase, and Web of Science. Macular and optic nerve head vascular density (VD) in patients with CAS were compared to controls. Pooled data for each outcome were calculated as standardized mean difference (SMD) and 95% confidence interval. OCTA parameters were analyzed using Review Manager Version 5.4.1 software. Results: Seven articles were included in this meta-analysis. Whole macular enface superficial and deep VD were significantly lower in patients with CAS than in controls (SMD = -0.97, P = 0.002; SMD = -1.05, P = 0.006, respectively). Additionally, the parafoveal superficial VD was significantly lower in the CAS group than in the healthy group (SMD = -0.71, P= 0.001). Radial peripapillary capillary (RPC) whole-image VD (SMD = -0.90, P< 0.0001), RPC inside disc VD (SMD = -0.49, P = 0.02), and RPC peripapillary VD (SMD = -0.64, P = 0.0003) were also significantly lower in patients with CAS compared to healthy individuals. Conclusion: These findings suggest that patients with CAS are prone to decreased VD in the macular and optic nerve head areas. Hence, OCTA shows potential as a promising tool for the early detection of cerebral microcirculation disorders due to CAS.http://www.sciencedirect.com/science/article/pii/S1572100024004277Carotid artery stenosisRetinal vasculature densityOptical coherence tomography angiographyMeta-analysis
spellingShingle Kaibao Ji
Yang Yang
Yiqiao Xing
Wei Wan
Metrics of retinal vasculature detected on OCTA in carotid artery stenosis: A systematic review and meta-analysis
Photodiagnosis and Photodynamic Therapy
Carotid artery stenosis
Retinal vasculature density
Optical coherence tomography angiography
Meta-analysis
title Metrics of retinal vasculature detected on OCTA in carotid artery stenosis: A systematic review and meta-analysis
title_full Metrics of retinal vasculature detected on OCTA in carotid artery stenosis: A systematic review and meta-analysis
title_fullStr Metrics of retinal vasculature detected on OCTA in carotid artery stenosis: A systematic review and meta-analysis
title_full_unstemmed Metrics of retinal vasculature detected on OCTA in carotid artery stenosis: A systematic review and meta-analysis
title_short Metrics of retinal vasculature detected on OCTA in carotid artery stenosis: A systematic review and meta-analysis
title_sort metrics of retinal vasculature detected on octa in carotid artery stenosis a systematic review and meta analysis
topic Carotid artery stenosis
Retinal vasculature density
Optical coherence tomography angiography
Meta-analysis
url http://www.sciencedirect.com/science/article/pii/S1572100024004277
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AT yiqiaoxing metricsofretinalvasculaturedetectedonoctaincarotidarterystenosisasystematicreviewandmetaanalysis
AT weiwan metricsofretinalvasculaturedetectedonoctaincarotidarterystenosisasystematicreviewandmetaanalysis