BACKGROUND: To contrast retinal and choroidal vascular alterations between carotid artery dissection (CAD) and carotid artery stenosis (CAS), and analyze their associations with cerebral infarction patterns and stenosis severity. METHODS: This observational study included stenotic-degree-matched patients with CAD and patients with CAS. Retinal ischemic signs-cotton wool spots, retinal artery occlusion, and paracentral acute middle maculopathy-were evaluated using fovea-centered optical coherence tomography/angiography. Retinal vascular density and choroidal metrics (choriocapillaris density, thickness, vascular volume, and index) were analyzed. RESULTS: =0.004). CONCLUSIONS: Compared with atherosclerotic stenosis, CAD exhibits a distinct oculovascular phenotype characterized by a higher burden of acute retinal ischemia but compensatory choroidal hyperperfusion. Retinal imaging serves as a noninvasive window into CAD pathophysiology, offering biomarkers for assessing hemodynamic stability and thromboembolic risk. REGISTRATION: URL: www.chictr.org.cn; Unique identifier: ChiCTR2300074640.
Cao et al. (Wed,) studied this question.