Ophthalmic artery stenosis on three-dimensional rotational angiography: interrater agreement, prevalence, and risk factors

ABSTRACT Background There is emerging interest in ophthalmic artery stenosis angioplasty for the treatment of age-related macular degeneration. Three-dimensional rotational angiography could be used intraoperatively to determine the presence and severity of ophthalmic artery stenosis. In patients who had undergone three-dimensional rotational angiography of the internal carotid artery, we aimed to assess the interrater agreement, prevalence, and risk factors for ophthalmic artery stenosis. Methods Consecutive patients from two centers who had undergone diagnostic cerebral angiography with three-dimensional rotational angiography of the internal carotid arteries were enrolled in this study. Three-dimensional rotational angiograms were independently double read for the presence of ophthalmic artery stenosis, as defined as an ostial narrowing of at least 50% when compared to the more distal ‘normal’ ophthalmic artery. Interrater agreement for the evaluation of ophthalmic artery stenosis was assessed with the Cohen’s kappa coefficient. Univariate and multivariable logistic regression were used to identify potential predictors of OA stenosis. Results 302 patients (97 men; mean±SD 57.6±13.4 years) were included in the analysis. Cohen’s kappa coefficient (95% CI) was 0.877 (0.798–0.956). Ophthalmic artery stenosis was present in 45 patients (14.9%). Multiple logistic regression demonstrated that female sex was independently associated with a higher odds of ophthalmic artery stenosis (odds ratio [OR]=2.70, 95% confidence interval [CI] 1.18-6.09, P=0.02). Smoking was a significant risk factor for ophthalmic artery stenosis (OR=2.11, 95% CI 1.10-4.06, P=0.03). Conclusion The evaluation of ophthalmic artery stenosis on three-dimensional rotational angiography had excellent interrater agreement. Ophthalmic artery stenosis was common and was associated with smoking and female sex.