Ocular microvascular changes in patients with sepsis: a prospective observational study

Area of Science:

• Critical Care Medicine
• Microcirculation Research
• Ophthalmology

Background:

• Sepsis significantly impacts systemic microcirculation.
• Conjunctival microcirculation offers a window into systemic vascular changes.
• Understanding microvascular alterations in sepsis is crucial for prognosis.

Purpose of the Study:

• To compare conjunctival microcirculation between septic patients and healthy controls.
• To assess changes in conjunctival and retinal microvasculature over 24 hours in sepsis survivors and non-survivors.
• To identify potential microcirculatory markers for sepsis outcomes.

Main Methods:

• Prospective observational study in a tertiary intensive care unit.
• Inclusion of 48 sepsis patients within 24 hours of ICU admission.
• Conjunctival and retinal imaging alongside hemodynamic monitoring at baseline, 6, and 24 hours.

Main Results:

• Septic patients displayed significantly reduced conjunctival microcirculatory parameters compared to healthy controls.
• Non-survivors had a significantly lower microvascular flow index (MFI) in conjunctival small vessels throughout the study period.
• No significant differences were observed in retinal arteriolar vessels between survivors and non-survivors.

Conclusions:

• Conjunctival microvascular blood flow is demonstrably altered in sepsis.
• Conjunctival microvascular flow index (MFI) may serve as a prognostic indicator in sepsis.
• Retinal arteriolar diameter did not differ between survivors and non-survivors in this cohort.