{
  "abstract": "BACKGROUND: Severe carotid artery stenosis or occlusion (CASO) is associated with white matter injury and cognitive impairment, but markers of accompanying microvascular dysfunction remain incompletely characterized. We investigated the relationships among retinal microvascular abnormalities on optical coherence tomography angiography, white matter hyperintensities (WMH), and cognitive impairment in severe unilateral CASO. METHODS: In this multicenter cross-sectional study, 860 participants were included: 566 patients with severe unilateral CASO without acute cerebral infarction and 294 control participants with similar age and sex distributions. All participants underwent multimodal imaging, including automated WMH segmentation on brain magnetic resonance imaging and macular optical coherence tomography angiography. Cognitive function was assessed using the Montreal Cognitive Assessment. RESULTS: <0.05). Retinal microvascular abnormalities and greater WMH burden were both associated with worse concurrent cognitive performance. Adding optical coherence tomography angiography metrics to clinical and WMH-based models provided modest additional discrimination for identifying concurrent cognitive impairment in internal cross-validation, increasing the area under the curve from 0.652 to 0.695 (Δarea under the curve, 0.043 [95% CI, 0.021-0.064]). CONCLUSIONS: In severe unilateral CASO, retinal microvascular abnormalities were associated with ipsilateral white matter injury and lower cognitive performance. Optical coherence tomography angiographymetrics provided modest complementary discriminatory information beyond conventional clinical variables and WMH for identifying concurrent cognitive impairment, although external validation is required. REGISTRATION: URL: https://www.chictr.org.cn/. Unique identifier: ChiCTR2300074640.",
  "abstract_shown": true,
  "affiliations": [
    "Sichuan University",
    "Chinese Academy of Sciences",
    "Capital Medical University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Le Cao",
      "orcid": "0000-0002-0414-9932"
    },
    {
      "affs": [
        0
      ],
      "name": "Yaqi Chen",
      "orcid": "0000-0003-3414-3061"
    },
    {
      "affs": [
        0
      ],
      "name": "Hang Wang",
      "orcid": "0000-0001-6021-739X"
    },
    {
      "affs": [
        2
      ],
      "name": "William Robert Kwapong",
      "orcid": "0000-0001-9633-4694"
    },
    {
      "affs": [
        1
      ],
      "name": "Shijia Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "Tianxiang Lan",
      "orcid": "0009-0005-2370-0178"
    },
    {
      "affs": [
        0
      ],
      "name": "Ruishan Liu",
      "orcid": "0009-0004-2079-7499"
    },
    {
      "affs": [
        0
      ],
      "name": "Ruosu Pan",
      "orcid": "0009-0007-1857-2604"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuying Yan"
    },
    {
      "affs": [
        0
      ],
      "name": "Wendan Tao",
      "orcid": "0000-0001-9950-9955"
    },
    {
      "affs": [
        0
      ],
      "name": "Guina Liu",
      "orcid": "0000-0002-6733-4262"
    },
    {
      "affs": [
        1
      ],
      "name": "Yitian Zhao",
      "orcid": "0000-0003-4357-4592"
    },
    {
      "affs": [
        0
      ],
      "name": "Bo Wu",
      "orcid": "0000-0003-2067-9965"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cttsnxjjc5m36.bib",
  "cited_by": 0,
  "doi": "10.1161/jaha.126.051820",
  "fulltext_url": null,
  "id": "cttsnxjjc5m36",
  "issns": [
    "2047-9980"
  ],
  "landing_url": "https://www.ahajournals.org/doi/10.1161/JAHA.126.051820",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Cerebrovascular and Carotid Artery Diseases"
    ]
  ],
  "openalex": "W7221335171",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-20",
  "publisher": "Ovid Technologies (Wolters Kluwer Health)",
  "ris": "https://research.draconitic.com/paper/cttsnxjjc5m36.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:28Z",
      "native_id": "10.1161/jaha.126.051820",
      "source": "crossref",
      "url": "https://www.ahajournals.org/doi/10.1161/JAHA.126.051820"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2047-9980",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Retinal Microvascular Abnormalities, White Matter Injury, and Cognitive Impairment in Carotid Stenosis or Occlusion",
  "title_text": "Retinal Microvascular Abnormalities, White Matter Injury, and Cognitive Impairment in Carotid Stenosis or Occlusion",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:28Z",
  "url": "https://research.draconitic.com/paper/cttsnxjjc5m36",
  "venue": "Journal of the American Heart Association",
  "versions": []
}