Evaluation of retinal and peripapillary vessel density and subfoveal choroidal thickness changes in patients undergoing cardiopulmonary bypass: An OCTA study.

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.

The association between cardiovascular risk profile and ocular microvascular changes in patients with non-ST elevation myocardial infarction.

PURPOSE: We aimed to evaluate the association between ocular microvasculature (vascular density) on optical coherence tomography-angiography (OCT-A) and the cardiovascular risk profile of patients hospitalized for non-ST-elevation myocardial infarction (NSTEMI) patients. METHODS: Patients admitted to the intensive care unit with the diagnosis of NSTEMI and undergoing coronary angiography were divided into 3 groups as low, intermediate, and high risk according to the SYNTAX score. OCT-A imaging was performed in all three groups. Right-left selective coronary angiography images of all patients were analyzed. The SYNTAX and TIMI risk scores of all patients were calculated. RESULTS: This study included opthalmological examination of 114 NSTEMI patients. NSTEMI patients with high SYNTAX risk scores had significantly lower deep parafoveal vessel density (DPD) than patients with low-intermediate SYNTAX risk scores (p < 0.001). ROC curve analysis found that a DPD threshold below 51.65 % was moderately associated with high SYNTAX risk scores in patients with NSTEMI. In addition, NSTEMI patients with high TIMI risk scores had significantly lower DPD than patients with low-intermediate TIMI risk scores (p < 0.001). CONCLUSIONS: OCT-A may be a non-invasive useful tool to assess the cardiovascular risk profile of NSTEMI patients with a high SYNTAX and TIMI score.

Optical cohorence tomography angiography findings in carotid artery stenosis.

AIM: To investigate vascular density (VD) changes in the superficial (SCP) and deep capillary plexus (DCP), radial peripapillar capillary plexus (RPCP), Foveal avascular zone (FAZ) and thickness changes of peripapillary retinal nerve fiber layer (ppRNFL) and choroid (CT) using optical coherence tomography angiography (OCTA) ipsilateral eyes of patient with internal carotid artery stenosis (ICAS) and to compare the obtained values with kontralateral eyes of patients with ICAS and healthy individuals. METHODS: This prospective cross-sectional case-control study was conducted in 43 patients with a diagnosis of unilateral ICAS and 47 age- and sex-matched healthy subjects. The patients were divided into three groups. Group 1 consisted of ipsilateral eyes of patients with ICAS, group 2 consisted of contralateral eyes of patients with CAS and group 3 comprised healthy individuals without ICAS, All participants underwent a comprehensive ophthalmologic examination including OCTA. RESULTS: FAZ, Superficial parafoveal and superficial superior VD were significantly lower in group 1 compared to group 2 (p = < 0.001, p = 0.018 and 0.021, respectively). Group 1 also had lower superficial superior (p = 0.038), superficial inferior (p = 0.034), deep superior (p = 0.034), and deep inferior (p = 0.012) VD compared to group 3. There was no significant difference between the groups in terms of ppRNFLT, whereas CT and RPC mean, superior, and inside-disc VD values were significantly lower in group 1 compared to both group 2 and 3 (p < 0.05). CONCLUSION: OCTA measurements may be useful in preventing irreversible ocular complications by detecting early structural changes in patients with ICAS before the development of symptomatic ocular ischemic syndrome.