Research Article
Evaluation of Subfoveal Choroidal Thickness in
Internal Carotid Artery Stenosis
Betül Elkay Sezgin Akçay,
1
Esra KardeG,
1
Sultan Maçin,
2
Cihan Ünlü,
1
Engin Bilge Özgürhan,
3
AydJn Maçin,
1
Tahir Kansu Bozkurt,
1
Ahmet Ergin,
1
and Reyhan Surmeli
4
1
Ophthalmology Clinic,
¨
Umraniye Research and Training Hospital, Istanbul, Turkey
2
Radiology Clinic,
¨
Umraniye Research and Training Hospital, Istanbul, Turkey
3
Beyo˘ glu Research and Training Hospital, Ophthalmology Clinic, Beyo˘ glu Research and Training Hospital, Istanbul, Turkey
4
Neurology Clinic,
¨
Umraniye Research and Training Hospital, Istanbul, Turkey
Correspondence should be addressed to Bet¨ ul
˙
Ilkay Sezgin Akc ¸ay; betul sezgin@yahoo.com
Received 28 August 2015; Revised 5 January 2016; Accepted 11 January 2016
Academic Editor: Lawrence S. Morse
Copyright © 2016 Bet¨ ul
˙
Ilkay Sezgin Akc ¸ay et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in
the elderly population. Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less
than 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode
and Doppler ultrasound. Te two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular
pressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyes were examined with the RTVue-100 OCT device
by the EDI-OCT technique. Results. Te mean age of the patients was 71.9 ± 10.8 years. Te mean percentage of ICA stenosis was
74 ± 4.9% in Group 1 and 47.5 ± 7.7% in Group 2. Te mean SFCT was 231.9 ± 44.6 m in Group 1 and 216.2 ± 46.8 m in Group
2, which was signifcantly lower ( = 0.028). A statistically signifcant positive correlation was found between the percentage of
internal carotid artery stenosis and SFCT ( = 0896, = 0.001). Conclusions. Compensatory SFCT increase can be seen in ipsilateral
internal carotid artery stenosis greater than 70%.
1. Introduction
Te choroid is a highly vascularized structure. Ninety-fve
percent of the blood fow into the eye supplies the uveal struc-
tures, and the choroid receives more than 70% of the portion
that enters the uveal structures [1]. Te ophthalmic artery, the
frst branch of the internal carotid artery (ICA), divides to
form the central retinal artery and the posterior ciliary artery,
which are responsible for the nourishment of the posterior
choroid [2, 3]. Te choroid lies between the lamina fusca of
the sclera and the retinal pigment epithelium [3]. Te main
function of the choroid is to provide oxygen and nourishment
to the outer retinal layers and uveal structures [4].
Te in vivo structure of the choroid cannot be visualized
properly with conventional methods such as fundus pho-
tography and fuorescein angiography due to the pigments
in the retinal pigment epithelium (RPE) that attenuate the
incident light. Indocyanine green angiography allows better
imaging of the choroidal vessels, but it does not provide
cross-sectional data. Recently, Spaide et al. demonstrated that
choroidal thickness could be measured successfully and non-
invasively in vivo using commercially available spectral-
domain optical coherence tomography (SD-OCT) devices
that use the enhanced depth imaging (EDI) technique [5].
Severe stenosis of the extracranial segment of internal
carotid artery (ICA) is the main reason for visual distur-
bances associated with ocular ischemia [6, 7]. Acute transient
monocular blindness due to entrapment of emboli in the
retinal arterial system is the most common ischemic ocular
symptom (30–40%) [8]. Reported range of chronic progres-
sive ocular ischemia in patients with carotid artery stenosis or
occlusion is 5–21% [9–12]. Extracranial carotid artery stenosis
Hindawi Publishing Corporation
Journal of Ophthalmology
Volume 2016, Article ID 5296048, 6 pages
http://dx.doi.org/10.1155/2016/5296048