Abstract Details

OCTA can image retinal vasculature without the need of dye injection. Previous studies have evaluated OCTA findings in the pre and post carotid revascularization procedures, however, none have evaluated the utility of OCTA in predicting the clinical outcome in ECAD associated stroke, which we aim to explore in this study.

To determine whether OCTA findings of retinal and Optic Nerve Head (ONH) can help predict functional outcomes (mRS) in patients with ECAD associated stroke.  

For this prospective study, OCTA findings in patients with ischemic stroke due to ECAD at 3-6 weeks of stroke onset was compared with mRS at 3 months. OCTA was also performed on risk factors matched controls who did not have carotid artery stenosis and the findings were compared with those of cases.

23 patients of ECAD stroke (cases arm) and 23 risk factor matched controls were enrolled. Mean age was 53.14± 12.28 years and majority were males (86.9%). There was a significant difference between cases and controls in the Deep Vessel Density (DVD), at macula (p = 0.0007) and in ONH Perfusion Density (p = 0.0007). Statistically significant difference was noted in the total vessel density at superficial macula (normal vs abnormal Superficial Vessel Density) in the ipsilateral eye and clinical outcome at 3 months ( very good vs poor outcome, mRS 0-1 vs mRS 2-6, respectively ( p= 0.0361). A positive correlation was also seen between ONH perfusion and NIHSS at the time of admission, mRS at discharge, and functional outcome (mRS) at 3 months of stroke onset (r =0.33, r=0.35, r=0.39, respectively), but none reached a statistical significance (p=0.11, p=0.09, p=0.06, respectively).

Further studies involving larger cohorts, could help establish OCTA as a new biomarker for predicting and monitoring clinical and functional outcomes in patients with Carotid Artery Stenosis, in a fast, non-invasive and reproducible manner.