Peripheral arterial disease (PAD) affects over 200 million people worldwide, causing increased morbidity from cardiovascular events such as stroke and myocardial infarction.
The study was conducted with the aim to see if retinal and choriocapillaris perfusion parameters were altered in patients with peripheral artery disease (PAD).
In this study, swept-source optical coherence tomography angiography (OCT-A) was used to image patients with PAD and healthy controls. Perfusion was assessed for vessel density (VD) and choriocapillaris non-perfused region using macula-centered 3x3 mm OCT-A images that were binarized. Fontaine staging, ankle-brachial-pressure-index (ABI), and vascular color-coded Doppler sonography were used in the clinical examination and non-invasive assessment.
The study included ninety-seven eyes from 52 PAD patients and thirty-four eyes from 23 healthy controls. Patients had less superficial retinal VD than controls (difference = -0.013, p = 0.02), it was lower with higher Fontaine stage (p = 0.01), and it was linked with ABI (r = 0.42, p <0.0001, 95% confidence interval [CI] 0.23–0.58).
The non-perfused area of the choriocapillaris was considerably higher in patients than in controls (difference = 3.64 %, p = 0.002, 95% CI 1.38–5.90 %), and it was strongly linked with ABI (r = − 0.22, p = 0.03, 95% CI − 0.40– − 0.03). All OCT-A characteristics had a significant association with ABI, while deep retinal vascular density and choriocapillaris non-perfused area had a significant association with Fontaine stage, according to multivariate multiple regression analysis.
Both retinal and choroidal perfusion were found to be severely impaired in this first research of retinal and choroidal perfusion in patients with PAD. OCT-A parameters can help in non-invasive PAD staging and monitoring by serving as indirect imaging biomarkers.