Retinal Perfusion and Injury in Sepsis and after Major Surgery.

Area of Science:

• Ophthalmology
• Critical Care Medicine
• Medical Imaging

Background:

• Sepsis is a life-threatening condition associated with widespread organ dysfunction.
• Retinal microcirculation may serve as a sensitive indicator of systemic circulatory changes.
• The impact of sepsis on retinal perfusion and its correlation with visual function requires further investigation.

Purpose of the Study:

• To assess retinal perfusion in sepsis patients compared to postoperative controls and healthy individuals.
• To evaluate the effects of reduced retinal perfusion on retinal structure and visual function.
• To explore the relationship between retinal perfusion and markers of organ dysfunction.

Main Methods:

• Prospective observational cohort study involving 24 sepsis patients, 45 ICU controls, and 15 healthy controls.
• Retinal perfusion assessed using Optical Coherence Tomography (OCT) angiography.
• Retinal structure (ganglion cell layer thickness) and visual function (Humphrey visual field analysis) evaluated using OCT and Humphrey visual field testing, respectively.

Main Results:

• Retinal perfusion was significantly lower in sepsis patients (37.4% lower than ICU controls, 59.7% lower than healthy controls).
• Reduced retinal perfusion correlated with Sequential Organ Failure Assessment (SOFA) scores.
• Impaired retinal perfusion predicted subsequent retinal ganglion cell layer thickening and worsening visual field mean deviation.

Conclusions:

• Sepsis leads to significant impairment of retinal perfusion, affecting both structure and function.
• Reduced retinal perfusion is linked to systemic organ dysfunction and predicts retinal damage.
• These findings highlight the retina as a potential window into the systemic effects of critical illness.