{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:35:53Z","timestamp":1791671753573,"version":"4.3.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">To contrast retinal and choroidal vascular alterations between carotid artery dissection (CAD) and carotid artery stenosis (CAS), and analyze their associations with cerebral infarction patterns and stenosis severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This observational study included stenotic\u2010degree\u2010matched patients with CAD and patients with CAS. Retinal ischemic signs\u2014cotton wool spots, retinal artery occlusion, and paracentral acute middle maculopathy\u2014were evaluated using fovea\u2010centered optical coherence tomography\/angiography. Retinal vascular density and choroidal metrics (choriocapillaris density, thickness, vascular volume, and index) were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The final analysis included 863 eyes from 467 participants (85 with CAD, 274 with CAS, 108 controls). Patients with CAD showed a significantly higher prevalence of paracentral acute middle maculopathy than Patients with CAS (6.4% versus 0.61%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Although ipsilateral eyes in both groups showed reduced retinal vascular density (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.017), a divergent pattern was observed in the choroid: CAD\u2010affected eyes demonstrated significantly higher choriocapillaris density, choroidal vascular volume, and choroidal thickness relative to both control and CAS\u2010affected eyes (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.017). Clinically, retinal ischemic signs in CAD were significantly associated with cerebral infarction (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.022) and severe stenosis\/occlusion (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.008). Notably, retinal signs correlated with cerebral infarction topography: subcortical infarctions were predominantly associated with paracentral acute middle maculopathy, whereas cortical infarctions were linked to cotton wool spots and retinal artery occlusion (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Compared with atherosclerotic stenosis, CAD exhibits a distinct oculovascular phenotype characterized by a higher burden of acute retinal ischemia but compensatory choroidal hyperperfusion. Retinal imaging serves as a noninvasive window into CAD pathophysiology, offering biomarkers for assessing hemodynamic stability and thromboembolic risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\">www.chictr.org.cn<\/jats:ext-link>\n                      ; Unique identifier: ChiCTR2300074640.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048079","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T09:10:17Z","timestamp":1778058617000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Retinal and Choroidal Vascular Alterations in Carotid Dissection Versus Atherosclerosis: Insights Into Divergent Ischemic Mechanisms"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0414-9932","authenticated-orcid":false,"given":"Le","family":"Cao","sequence":"first","affiliation":[{"name":"Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6021-739X","authenticated-orcid":false,"given":"Hang","family":"Wang","sequence":"additional","affiliation":[{"name":"Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzuo","family":"Shang","sequence":"additional","affiliation":[{"name":"Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9633-4694","authenticated-orcid":false,"given":"William Robert","family":"Kwapong","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2079-7499","authenticated-orcid":false,"given":"Ruishan","family":"Liu","sequence":"additional","affiliation":[{"name":"Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2370-0178","authenticated-orcid":false,"given":"Tianxiang","family":"Lan","sequence":"additional","affiliation":[{"name":"Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6733-4262","authenticated-orcid":false,"given":"Guina","family":"Liu","sequence":"additional","affiliation":[{"name":"West China Second University Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1487-3382","authenticated-orcid":false,"given":"Fayun","family":"Hu","sequence":"additional","affiliation":[{"name":"Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2067-9965","authenticated-orcid":false,"given":"Bo","family":"Wu","sequence":"additional","affiliation":[{"name":"Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2025-004186"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.52216"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.534669"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd10050210"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci12080979"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.033081"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.12.9.3"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000003453"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.13.8.5"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000004354"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.045731"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0034823"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012125"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10081938"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.4103\/bc.bc_36_22"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2025.1560482"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajoc.2022.101704"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.18240\/ijo.2019.05.21"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000457"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-025-03616-y"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000128520.37674.EF"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000128518.26834.93"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.02.059"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.51329\/mehdiophthal1509"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjophth-2020-000467"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.64.15.42"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xops.2024.100651"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2025.10.002"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2024.05.031"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2020.100884"}],"container-title":["Journal 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