J Korean Ophthalmol Soc.  2021 Feb;62(2):237-242. 10.3341/jkos.2021.62.2.237.

Decreased Retinal Nerve Fiber Thickness in Asymptomatic Carotid Stenosis

  • 1Department of Ophthalmology, Veterans Health Service Medical Center, Seoul, Korea
  • 2Department of Neurology, Veterans Health Service Medical Center, Seoul, Korea


To investigate the relationship between retinal nerve fiber layer (RNFL) thickness and carotid artery stenosis (CAS).
We retrospectively reviewed the medical records of 106 patients who underwent both optical coherence tomography to determine RNFL and carotid artery sonography within 1 year. The RNFL was divided into four quadrants, and each quadrant’s RNFL thickness and average thickness were compared with the artery endothelial thickness, the presence of plaque, and the degree of CAS. A multiple regression analysis was performed to assess the relationship between RNFL and CAS.
The presence of carotid artery plaque had a significant association with a decrease in the average RNFL thickness (p = 0.039). There was no statistically significant difference in age or risk factors associated with vascular disease, with the exception of carotid endothelial thickness and the total cholesterol level in the two groups, depending on the presence of total carotid plaque. RNFL thickness was confirmed to be related to age and total cholesterol levels using linear univariate regression analysis. In a multivariable linear regression analysis, with age and total cholesterol levels controlled, the presence of carotid artery plaque was significantly associated with a decrease in average RNFL thickness (p = 0.026).
Asymptomatic CAS may be associated with a decrease in average RNFL thickness. In patients with decreased RNFL thickness without any ophthalmic diseases, carotid artery examination should be considered.


Carotid stenosis, Optical coherence tomography, Retinal nerve fiber layer
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