Association of retinal microvascular abnormalities with cardiovascular diseases in patients with severe carotid artery stenosis.

PURPOSE: To investigate and summarize the characteristics of retinal microvascular abnormalities (RMAs) in patients with severe carotid artery stenosis (CAS) and explore the association between the presence of RMAs and cardiovascular diseases (CVD).

METHODS

Color fundus photography and wide-field swept-source optical coherence tomography angiography (SS-OCTA) examinations were performed on all participants. Images were reviewed to identify RMAs. The occurrence and characteristics of RMAs were summarized. CAS patients with or without CVD were divided into different groups, and the association between the presence of RMAs and CVD were explored using multivariable logistic regression analysis.

RESULTS

This observational, cross-sectional study included 258 eyes from 129 patients with severe CAS. A total of 39/129 patients (30.2%) were identified with RMAs. These RMAs included branch retinal artery occlusion, asymptomatic retinal emboli, cotton wool spots, retinal hemorrhage, branch retinal vein occlusion, inner retinal layer hyperreflectivity, retinal nonperfusion and neovascularization of the optic disk. Multivariable logistic regression analysis revealed that RMAs was significantly associated with the presence of CVD in patients with severe CAS.

CONCLUSIONS

This cross-sectional study summarized the characteristics of RMAs associated with CAS and identified RMAs as biomarkers of CVD in patients with severe CAS. Patients with RMAs were at high risk and should be carefully managed.