{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:38:37Z","timestamp":1787312317854,"version":"build-2736575974"},"reference-count":56,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research, Development, and Innovation Office","award":["129277"],"award-info":[{"award-number":["129277"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The Circle of Willis (CoW) is the main collateral system, and its morphological variants are more common in patients who have severe carotid artery stenosis. Earlier data suggest that optical coherence tomography angiography (OCTA) may help to assess the changes in cerebral vascular perfusion by imaging the retinal blood flow. In this single-center prospective clinical study, patients scheduled for carotid endarterectomy (CEA) underwent preoperative computed tomography angiography (CTA) of the extra- and intracranial cerebral circulation. OCTA imaging was performed one week before surgery and postoperatively one month later. The patients were divided into two subgroups based on CTA evaluation of CoW: compromised CoW or non-compromised CoW (containing hypoplastic and normal segments). The effect of the patient\u2019s age, OCTA scan quality (SQ), CoW morphology, laterality, and surgery on superficial capillary vessel density (VD) in the macula were assessed in multivariable regression models using linear mixed models. We found that VD significantly decreased with aging (\u22120.12%; 95%CI: \u22120.07\u2013\u22120.15; p &lt; 0.001) and was significantly higher in patients with non-compromised CoW morphology (by 0.87% 95%CI (0.26\u20131.50); p = 0.005). After CEA, retinal blood flow significantly improved by 0.71% (95%CI: 0.18\u20131.25; p = 0.01). These results suggest that in the case of carotid artery occlusion, patients with non-compromised CoW have more preserved ocular blood flow than subjects with compromised CoW due to remodeling of the intra-orbital blood flow. Measuring the retinal blood flow might be used as a relevant and sensitive indicator of collateral cerebrovascular circulation.<\/jats:p>","DOI":"10.3390\/jcm12165335","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T10:47:02Z","timestamp":1692269222000},"page":"5335","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Effect of Circle of Willis Morphology on Retinal Blood Flow in Patients with Carotid Stenosis Measured by Optical Coherence Tomography Angiography"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0886-3674","authenticated-orcid":false,"given":"Zsuzsanna","family":"Mih\u00e1ly","sequence":"first","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Heart and Vascular Centre, Semmelweis University, 1122 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilla","family":"Istv\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Czak\u00f3","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fruzsina","family":"Beny\u00f3","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1578-3354","authenticated-orcid":false,"given":"Sarolta","family":"Borzs\u00e1k","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Heart and Vascular Centre, Semmelweis University, 1122 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Varga","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Heart and Vascular Centre, Semmelweis University, 1122 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-9484","authenticated-orcid":false,"given":"Rita","family":"Magyar-Stang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter Vince","family":"Banga","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Heart and Vascular Centre, Semmelweis University, 1122 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1gnes","family":"\u00c9l\u0151","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00f3bert","family":"Debreczeni","sequence":"additional","affiliation":[{"name":"Department of Neurology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ill\u00e9s","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Ophthalmology, Weill Cornell Medical College, New York, NY 10021, USA"},{"name":"Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"S\u00f3tonyi","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Heart and Vascular Centre, Semmelweis University, 1122 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"key":"ref_1","first-page":"S0741","article-title":"Society for Vascular Surgery clinical practice guidelines for management of extracranial cerebrovascular disease","volume":"18","author":"AbuRahma","year":"2021","journal-title":"J. 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