Evaluation of ocular blood flow in the assessment of symptomatic carotid stenosis

Matthew T Jones; Sebastian Sanchez; Rishi R Patel; Ashrita Raghuram; Jacob M Miller; Ryuya Hashimoto; Randy Kardon; Edgar A Samaniego

doi:10.1177/15910199231169844

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Evaluation of ocular blood flow in the assessment of symptomatic carotid stenosis

Journal article

Open access

Peer reviewed

Evaluation of ocular blood flow in the assessment of symptomatic carotid stenosis

Matthew T Jones, Sebastian Sanchez, Rishi R Patel, Ashrita Raghuram, Jacob M Miller, Ryuya Hashimoto, Randy Kardon and Edgar A Samaniego

Interventional neuroradiology, Vol.31(4), pp.475-481

08/2025

DOI: 10.1177/15910199231169844

PMCID: PMC12280265

PMID: 37070150

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https://pmc.ncbi.nlm.nih.gov/articles/PMC12280265/pdf/10.1177_15910199231169844.pdfView

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Abstract

The degree of internal carotid artery (ICA) stenosis determined by criteria from the North American Symptomatic Carotid Endarterectomy Trial (NASCET) is not the most accurate index to assess distal flow compromise. Distal ICA perfusion is also determined by factors such as tandem carotid stenosis and collateral circulation. Quantification of end-organ ocular perfusion using non-invasive laser speckle flowgraphy (LSFG) may provide insights into distal ICA flow. This study prospectively assessed the degree of ICA flow using LSFG. Eighteen patients with symptomatic carotid stenosis underwent LSFG evaluation. LSFG was used to extract ocular blood flow metrics recorded simultaneously in the retina, choroid, and optic nerve head. The following ocular flow parameters were measured with LSFG: mean blur rate (MBR), flow acceleration index (FAI), and rising rate (RR). iFlow perfusion imaging was used to objectively quantify contrast flow in the ICA and brain parenchyma during digital subtraction angiography. Time to peak (TTP) and contrast delay were extracted from seven different regions of interest (ROIs). MBR, FAI, and RR were correlated with NASCET degree of stenosis. FAI and RR also improved after stenting. TTP improved after stenting in three ROIs. A moderate negative correlation was observed between FAI and contrast delay. LSFG non-invasively quantifies end-organ blood flow distal to the ICA origin. LSFG metrics have the potential to quantify end-organ perfusion and determine if a proximal carotid stenosis is symptomatic.

Carotid stenosis

collateral circulation

reperfusion

Details

Title: Subtitle: Evaluation of ocular blood flow in the assessment of symptomatic carotid stenosis
Creators: Matthew T Jones - University of Iowa Hospitals and Clinics
Sebastian Sanchez - University of Iowa
Rishi R Patel - University of Iowa Hospitals and Clinics
Ashrita Raghuram - University of Iowa
Jacob M Miller - University of Iowa
Ryuya Hashimoto - University of Iowa
Randy Kardon - University of Iowa Hospitals and Clinics
Edgar A Samaniego - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Interventional neuroradiology, Vol.31(4), pp.475-481
DOI: 10.1177/15910199231169844
PMID: 37070150
PMCID: PMC12280265
NLM abbreviation: Interv Neuroradiol
ISSN: 1591-0199
eISSN: 2385-2011
Grant note: name: Iowa City VA Center for the Prevention and Treatment of Visual Loss
Language: English
Electronic publication date: 04/17/2023
Date published: 08/2025
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Orthopedics and Rehabilitation; Surgery; Neurosurgery; Ophthalmology and Visual Sciences
Record Identifier: 9984398208602771

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