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Retinal small vessel dilatation in the systemic inflammatory response to surgery
Alexander Grogan1,2, Karen Barclay2, Deb Colville1
1Department of Medicine (Melbourne Health and Northern Health), The University of Melbourne, Parkville, VIC, 3050, Australia.
Scientific Reports
|August 2, 2022
Summary
Surgery causes temporary dilation of retinal microvasculature, potentially affecting its use as a cardiac event predictor. This study shows post-operative changes in small vessel size, highlighting a need for careful interpretation in hospital patients.
Area of Science:
- Ophthalmology
- Cardiology
- Vascular Biology
Background:
- Retinal microvascular calibre is a proposed predictor of cardiac events.
- Surgery induces inflammation, potentially altering small vessel calibre.
- The impact of surgery on retinal vessel calibre and its predictive value for cardiac risk requires investigation.
Purpose of the Study:
- To examine the effects of surgery on retinal and systemic small vessel size.
- To assess the confounding effect of surgery on using retinal vessel calibre to predict cardiac risk in hospital patients.
Main Methods:
- Retinal imaging was performed on 68 participants before and within 3 days after surgery.
- Vessel calibre was graded using semi-automated software (Parr-Hubbard formula with Knudtson's modification).
- Differences in calibre and inflammatory markers (CRP, albumin) were analyzed using statistical tests and regression analysis.
Main Results:
- Post-operative C-reactive protein levels increased, and serum albumin decreased significantly (p < 0.01).
- Mean central retinal arteriole and venular equivalent calibre (CRAE, CRVE) increased post-operatively (p < 0.01).
- These microvascular changes occurred within 3 days of surgery.
Conclusions:
- The systemic microvasculature, including retinal vessels, dilates post-operatively, likely due to inflammation and endothelial dysfunction.
- Post-operative microvascular dilatation may confound the use of small vessel calibre as a cardiac risk predictor in surgical inpatients.
- Inflammatory stimuli like pneumonia can also cause microvascular changes, posing a known confounder in hospital settings.
