Optical Coherence Tomography Angiography and Carotid Intima Media Thickness in Normotensive Patients with Autosomal Dominant Polycystic Kidney Disease and Preserved Kidney Function

Subclinical vascular abnormalities may develop in autosomal dominant polycystic kidney disease (ADPKD) prior to the onset of hypertension or kidney dysfunction. This cross-sectional case–control study compared carotid intima–media thickness (CIMT) and optical coherence tomography angiography (OCTA) parameters in 20 normotensive patients with ADPKD and preserved kidney function, as well as in 20 healthy controls who were matched by age and sex. CIMT was measured by ultrasonography, and right-eye OCTA was used to assess macular and peripapillary vessel density, foveal avascular zone indices, and retinal and choroidal flow areas. CIMT was greater in patients with ADPKD than in controls (median, 0.6 mm versus 0.3 mm; p < 0.001). After adjusting for age, systolic blood pressure, and body mass index, ADPKD status remained independently associated with greater CIMT (B = 0.270 mm; 95% confidence interval, 0.189–0.350; p < 0.001). No statistically significant between-group differences were detected in the assessed OCTA parameters, and no significant correlations were identified between CIMT and OCTA measurements. These findings suggest the presence of subclinical large-artery structural abnormalities in this specific ADPKD population despite the absence of detectable differences in OCTA. Larger longitudinal studies are needed to clarify the prognostic significance and temporal evolution of these vascular findings.