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Objective <p>To compare fundus characteristics between ipsilateral and contralateral eyes in patients with unilateral severe carotid artery stenosis (SCAS) and explore their association with acute cerebral infarction (ACI).</p> Methods <p>One hundred twelve patients were included in this cross-sectional study and underwent detailed ophthalmic examinations. Retinal vessel diameters were assessed by calculating central retinal arterial equivalent (CRAE), venular equivalent (CRVE), and objective arterio-venular ratio (oAVR). Retinal microvascular abnormalities (RMAs) were assessed by evaluating and grading retinal arteriolar, venular, and arterio-venular characteristics, and by summing up the points in RMAs assessment, the total vascular abnormality scores (TVAS) were obtained. Retinopathies were assessed using multimodel imaging. Interocular asymmetry and its association with ACI were analyzed.</p> Results <p>Ipsilateral eyes showed significantly larger CRVE (228.8 ± 22.5&#xa0;μm vs. 222.6 ± 22.5&#xa0;μm, <i>p</i> = 0.002), higher frequencies of oAVR &lt; 2/3 (65.2% vs. 51.8%, <i>p</i> = 0.042), macular venular tortuosity (VTM) (52.7% vs. 39.3%, <i>p</i> = 0.044), TVAS &gt; 10 (22.3% vs. 9.8%, <i>p</i> = 0.011), and retinal lesions (22.3% vs. 4.5%, <i>p</i> &lt; 0.001). Multivariate regression identified ipsilateral VTM (OR = 3.342, 95%CI:1.119–9.978, <i>p</i> = 0.031) and ipsilateral TVAS &gt; 10 (OR = 3.624, 95%CI:1.142–11.501, <i>p</i> = 0.029) as independent risk factors associated with ACI.</p> Conclusions <p>Asymmetric fundus features may indicate unilateral carotid disease. Ipsilateral VTM and a high TVAS are associated with ACI and warrant close monitoring in SCAS patients.</p>

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Interocular asymmetry of fundus characteristics in patients with unilateral severe carotid artery stenosis

  • 期刊论文

  • 发表日期：

    2026年3月30日

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  • Li Zhang,
  • Ni Han,
  • Chun-Yan Lei,
  • Fei-Peng Jiang,
  • Tian-Yu Yang,
  • Zhi-Hao Xiao,
  • Sheng Gao,
  • Mei-Xia Zhang

摘要

Objective

To compare fundus characteristics between ipsilateral and contralateral eyes in patients with unilateral severe carotid artery stenosis (SCAS) and explore their association with acute cerebral infarction (ACI).

Methods

One hundred twelve patients were included in this cross-sectional study and underwent detailed ophthalmic examinations. Retinal vessel diameters were assessed by calculating central retinal arterial equivalent (CRAE), venular equivalent (CRVE), and objective arterio-venular ratio (oAVR). Retinal microvascular abnormalities (RMAs) were assessed by evaluating and grading retinal arteriolar, venular, and arterio-venular characteristics, and by summing up the points in RMAs assessment, the total vascular abnormality scores (TVAS) were obtained. Retinopathies were assessed using multimodel imaging. Interocular asymmetry and its association with ACI were analyzed.

Results

Ipsilateral eyes showed significantly larger CRVE (228.8 ± 22.5 μm vs. 222.6 ± 22.5 μm, p = 0.002), higher frequencies of oAVR < 2/3 (65.2% vs. 51.8%, p = 0.042), macular venular tortuosity (VTM) (52.7% vs. 39.3%, p = 0.044), TVAS > 10 (22.3% vs. 9.8%, p = 0.011), and retinal lesions (22.3% vs. 4.5%, p < 0.001). Multivariate regression identified ipsilateral VTM (OR = 3.342, 95%CI:1.119–9.978, p = 0.031) and ipsilateral TVAS > 10 (OR = 3.624, 95%CI:1.142–11.501, p = 0.029) as independent risk factors associated with ACI.

Conclusions

Asymmetric fundus features may indicate unilateral carotid disease. Ipsilateral VTM and a high TVAS are associated with ACI and warrant close monitoring in SCAS patients.