Subfoveal choroidal thickness in ipsi‐ and contralateral eyes of patients with carotid stenosis before and after carotid endarterectomy: a prospective study

Abstract

Purpose To compare subfoveal choroidal thickness (SFCT) and associated clinical variables in patients with carotid stenosis (CS) before and 6 months after carotid endarterectomy (CEA). Methods The prospective non‐randomized Helsinki Carotid Endarterectomy Study – Brain and Eye Sub‐sTudy included seventy patients (81% male, mean age 69 years) and 40 control subjects (77% male, 68 years), from March 2015 to December 2018. Ophthalmological examination included SFCT measured with enhanced‐depth imaging‐optical coherence tomography. Carotid stenosis (CS) was more severe (≥70% stenosis in 92%) ipsilateral to the CEA than contralaterally (<50% stenosis in 74%; p < 0.001). Results At baseline, patients had thinner mean SFCT than control subjects in both eyes (ipsilateral, 222 versus 257 μm and contralateral, 217 versus 258 μm, p ≤ 0.005). At follow‐up, SFCT did not change in ipsi‐ and contralateral eyes compared to baseline in patients (p = 0.68 and p = 0.77), or in control subjects (p = 0.59 and p = 0.79). Patients with coronary artery disease had thinner mean SFCT versus those without it in ipsilateral eyes before CEA (200 versus 233 μm, p = 0.027). In ipsilateral eyes of patients before CEA, thinner SFCT and ocular signs of CS, plaque and hypoperfusion related findings combined, were associated (p = 0.036), and the best‐corrected visual acuity, measured in logMAR, increased with increasing SFCT (r = −0.25; p = 0.046). Conclusions Subfoveal choroidal thickness (SFCT) is thinner in patients with CS without association between SFCT and the grade of CS. Unchanged SFCT after CEA suggests, that choroidal vessels in severe CS are unable to react to increased blood flow. Bilaterally thin SFCT could be considered as yet another sign of CS.

Ocular signs of carotid stenosis in ipsi‐ and contralateral eyes before and after carotid endarterectomy: a prospective study

“…The same all‐Caucasian study population took part in our study concerning subfoveal choroidal thickness (SFCT) (Ala‐Kauhaluoma et al. 2020).…”

“…One control subject excluded from the previous work, for lacking SFCT measurements, was included in this work (Ala‐Kauhaluoma et al. 2020). CEA was right‐sided in 29 patients (41%) and left‐sided in 41 (59%).…”

Flicker‐induced retinal vascular dilation in ipsi‐ and contralateral eyes of patients with carotid stenosis before and after carotid endarterectomy: a prospective study

“…We examined 71 eligible patients and 42 healthy controls between March 2015 and December 2018 in Helsinki University Hospital, Finland, including patients who had CS of 70% or more in their first computed tomography angiography (CTA) evaluation. Part of the data concerning this same cohort has been published earlier (Ala-Kauhaluoma et al 2020;Ala-Kauhaluoma et al 2021). We excluded patients with a recent (<6 months) cerebral infarction and excluded the DVA data of participants who had used caffeine or nicotine within 3 hours prior to the examination.…”

“…Part of the data concerning this same cohort has been published earlier (Ala‐Kauhaluoma et al . 2020 ; Ala‐Kauhaluoma et al . 2021 ).…”

“…Enhanced‐depth spectral‐domain optical coherence tomography (EDI‐OCT) (Heidelberg Spectralis; version 6.3.2.0; Heidelberg Engineering, Heidelberg, Germany) allowed us to measure subfoveal choroidal thickness (SFCT) (Ala‐Kauhaluoma et al . 2020 ).…”