Evaluation of retinal and peripapillary vessel density and subfoveal choroidal thickness changes in patients
Göksu Hande Naz Şimdivar1, Tuğba Kurumoğlu İncekalan1, Akif Gündüz2
1Department of Ophthalmology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey.
Insights
Coronary artery bypass grafting (CABG) surgery did not permanently affect retinal blood flow. However, longer aortic cross-clamp and cardiopulmonary bypass times may impact optic nerve blood flow, requiring clinical vigilance for ocular issues.
Area of Science:
- Ophthalmology
- Cardiovascular Surgery
- Medical Imaging
Background:
- Coronary artery bypass grafting (CABG) is a major surgical procedure.
- Understanding potential ocular hemodynamic changes after CABG is crucial for patient care.
Purpose of the Study:
- To investigate hemodynamic alterations in the retina, peripapillary region, and choroid of patients undergoing CABG.
- To assess the impact of surgical duration on these ocular parameters.
Main Methods:
- Prospective case series of 35 patients undergoing CABG.
- Optical coherence tomography angiography (OCTA) used to evaluate vessel density (VD) and choroidal thickness.
- Measurements taken pre-surgery and two weeks post-surgery, correlated with aortic cross-clamp (ACC) and cardiopulmonary bypass (CPB) durations.
Main Results:
- No significant differences in OCTA measurements were observed between pre- and post-CABG assessments.
- Inside-disc VD showed a negative correlation with both ACC and CPB durations.
- Peripapillary inferior hernia and mean peripapillary VD demonstrated negative correlations with CPB duration.
Conclusions:
- The cardiopulmonary bypass procedure does not appear to cause permanent ocular hemodynamic changes.
- Prolonged aortic cross-clamp and cardiopulmonary bypass times are associated with optic nerve blood flow changes.
- Clinicians should monitor for postoperative ocular complications, especially after extended surgical procedures.
Purpose:
We aimed to investigate hemodynamic changes in the retina, peripapillary area, and choroid in patients undergoing coronary artery bypass grafting (CABG).
Methods:
This prospective case series included 35 eyes of 35 patients. Vessel density (VD) of superficial capillary plexus, deep capillary plexus, radial peripapillary capillary, foveal avascular zone area, and subfoveal choroidal thickness changes were evaluated using optical coherence tomography angiography (OCTA) 1 day before and 2 weeks after surgery. The correlation of these parameters with aortic cross-clamp (ACC) duration and cardiopulmonary bypass (CPB) duration was evaluated.
Results:
There were no differences in the OCTA measurements of the patients after CABG compared to before surgery (P > 0.05). Inside-disc VD showed a negative correlation with both ACC (P = 0.036) and CPB duration (P = 0.048); peripapillary inferior hernia showed a negative correlation with both ACC (P = 0.042) and CPB duration (P = 0.027). Another negative correlation was observed between mean peripapillary VD and CPB duration (P = 0.039).
Conclusion:
The CPB procedure had no permanent effect on retinal choroid and optic disc blood flow postoperatively. Prolonged ACC and CPB times seem to be important in terms of optic nerve blood flow. Clinicians should be alert for postoperative ocular complications after long surgeries.
