ArticlePloS one2023
Impaired cerebrovascular reactivity correlates with reduced retinal vessel density in patients with carotid artery stenosis: Cross-sectional, single center study.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Associations between carotid macrovascular and retinal microvascular alterations in diabetes: Evidence synthesis and implications for risk assessment.Atherosclerosis plus · 2026Review
- Image Quality as an Important Confounder in Quantitative OCT Angiography: A Review with Quantitative Synthesis.Medical sciences (Basel, Switzerland) · 2026Review
- Concomitant Dysregulation of Cerebral Vasoreactivity and Arterial Blood Pressure Is Closely Related in Patients with Carotid Stenosis.Life (Basel, Switzerland) · 2026Article
- Complex Characterization of Cerebral Vasoreactivity in Internal Carotid Artery Stenotic Patients with Transcranial Doppler Sonography.Life (Basel, Switzerland) · 2025Article
- Differential Gene and Protein Expressions Responsible for Vasomotor Signaling Provide Mechanistic Bases for the Opposite Flow-Induced Responses of Pre- and Post-Circle of Willis Arteries.Life (Basel, Switzerland) · 2025Article
- Development of the European Society of Hypertension guidelines for the management of arterial hypertension: comparison of the helpfulness of ESH 2013, 2018, and 2023 guidelines.Journal of hypertension · 2025Article
- Bilateral Cerebral Hypoperfusion in Asymptomatic Unilateral Carotid Artery Stenosis: An Arterial Spin Labeling MRI Study.Medicina (Kaunas, Lithuania) · 2025Article
- Atherosclerotic burden and cerebral small vessel disease: exploring the link through microvascular aging and cerebral microhemorrhages.GeroScience · 2024Review
- Non-Invasive Tools in Perioperative Stroke Risk Assessment for Asymptomatic Carotid Artery Stenosis with a Focus on the Circle of Willis.Journal of clinical medicine · 2024Review
- Advances in retinal imaging biomarkers for the diagnosis of cerebrovascular disease.Frontiers in neurology · 2024Review
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Authors and funding
13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe cerebral and retinal circulation systems are developmentally, anatomically, and physiologically interconnected. Thus, we hypothesized that hypoperfusion due to atherosclerotic stenosis of the internal carotid artery (ICA) can result in disturbances of both cerebral and retinal microcirculations. We aimed to characterize parameters indicating cerebrovascular reactivity (CVR) and retinal microvascular density in patients with ICA stenosis, and assess if there is correlation between them.
methodsIn this cross-sectional study the middle cerebral artery (MCA) blood flow velocity was measured by transcranial Doppler (TCD) and, simultaneously, continuous non-invasive arterial blood pressure measurement was performed on the radial artery by applanation tonometry. CVR was assessed based on the response to the common carotid artery compression (CCC) test. The transient hyperemic response ratio (THRR) and cerebral arterial resistance transient hyperemic response ratio (CAR-THRR) were calculated. Optical coherence tomography angiography (OCTA) was used to determine vessel density (VD) on the papilla whole image for all (VDP-WIall) and for small vessels (VDP-WIsmall). The same was done in the peripapillary region: all (VDPPall), and small (VDPPsmall) vessels. The VD of superficial (VDMspf) and deep (VDMdeep) macula was also determined. Significance was accepted when p<0.05.
resultsTwenty-four ICA stenotic patients were evaluated. Both CVR and retinal VD were characterized. There was a significant, negative correlation between CAR-THRR (median = -0.40) and VDPPsmall vessels (median = 52%), as well as between VDPPall vessels (median = 58%), and similar correlation between CAR-THRR and VDP-WIsmall (median = 49.5%) and between VDP-WIall (median = 55%).
conclusionThe significant correlation between impaired cerebrovascular reactivity and retinal vessel density in patients with ICA stenosis suggests a common mechanism of action. We propose that the combined use of these diagnostic tools (TCD and OCTA) helps to better identify patients with increased ischemic or other cerebrovascular risks.
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