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Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock
BACKGROUND: This study aimed to investigate the feasibility of optical coherence tomography angiography (OCT-A) for quantitative analysis of flow density to assess changes in retinal perfusion in an experimental model of haemorrhagic shock. METHODS: Haemorrhagic shock was induced in five healthy, an...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5975442/ https://www.ncbi.nlm.nih.gov/pubmed/29843760 http://dx.doi.org/10.1186/s13054-018-2056-3 |
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author | Alnawaiseh, Maged Ertmer, Christian Seidel, Laura Arnemann, Philip Helge Lahme, Larissa Kampmeier, Tim-Gerald Rehberg, Sebastian Willy Heiduschka, Peter Eter, Nicole Hessler, Michael |
author_facet | Alnawaiseh, Maged Ertmer, Christian Seidel, Laura Arnemann, Philip Helge Lahme, Larissa Kampmeier, Tim-Gerald Rehberg, Sebastian Willy Heiduschka, Peter Eter, Nicole Hessler, Michael |
author_sort | Alnawaiseh, Maged |
collection | PubMed |
description | BACKGROUND: This study aimed to investigate the feasibility of optical coherence tomography angiography (OCT-A) for quantitative analysis of flow density to assess changes in retinal perfusion in an experimental model of haemorrhagic shock. METHODS: Haemorrhagic shock was induced in five healthy, anaesthetized sheep by stepwise blood withdrawal of 3 × 10 ml∙kg(− 1) body weight. OCT-A imaging of retinal perfusion was performed using an OCT device. Incident dark-field illumination microscopy videos were obtained for the evaluation of conjunctival microcirculation. Haemodynamic variables and flow density data in the OCT angiogram were analysed before and during progressive haemorrhage resulting in haemorrhagic shock as well as after fluid resuscitation with 10 ml∙kg(− 1) body weight of balanced hydroxyethyl starch solution (6% HES 130/0.4). Videos of the conjunctival microcirculation were recorded at baseline, in haemorrhagic shock, and after resuscitation. Data are presented as median with interquartile range. Comparisons between time points were made using Friedman’s test and the degree of correlation between two variables was expressed as Spearman’s rank correlation coefficient. RESULTS: Mean arterial pressure and cardiac index (CI) decreased and lactate concentration increased after induction of shock, and haemodynamics recovered after resuscitation. The flow density in the superficial retinal OCT angiogram decreased significantly after shock induction (baseline 44.7% (40.3; 50.5) vs haemorrhagic shock 34.5% (32.8; 40.4); P = 0.027) and recovered after fluid resuscitation (46.9% (41.7; 50.7) vs haemorrhagic shock; P = 0.027). The proportion of perfused vessels of the conjunctival microcirculation showed similar changes. The flow density measured using OCT-A correlated with the conjunctival microcirculation (perfused vessel density: Spearman’s rank correlation coefficient ρ = 0.750, P = 0.001) and haemodynamic parameters (CI: ρ = 0.693, P < 0.001). CONCLUSIONS: Retinal flow density, measured using OCT-A, significantly decreased in shock and recovered after fluid therapy in an experimental model of haemorrhagic shock. OCT-A is feasible to assess changes in retinal perfusion in haemorrhagic shock and fluid resuscitation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13054-018-2056-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5975442 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-59754422018-05-31 Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock Alnawaiseh, Maged Ertmer, Christian Seidel, Laura Arnemann, Philip Helge Lahme, Larissa Kampmeier, Tim-Gerald Rehberg, Sebastian Willy Heiduschka, Peter Eter, Nicole Hessler, Michael Crit Care Research BACKGROUND: This study aimed to investigate the feasibility of optical coherence tomography angiography (OCT-A) for quantitative analysis of flow density to assess changes in retinal perfusion in an experimental model of haemorrhagic shock. METHODS: Haemorrhagic shock was induced in five healthy, anaesthetized sheep by stepwise blood withdrawal of 3 × 10 ml∙kg(− 1) body weight. OCT-A imaging of retinal perfusion was performed using an OCT device. Incident dark-field illumination microscopy videos were obtained for the evaluation of conjunctival microcirculation. Haemodynamic variables and flow density data in the OCT angiogram were analysed before and during progressive haemorrhage resulting in haemorrhagic shock as well as after fluid resuscitation with 10 ml∙kg(− 1) body weight of balanced hydroxyethyl starch solution (6% HES 130/0.4). Videos of the conjunctival microcirculation were recorded at baseline, in haemorrhagic shock, and after resuscitation. Data are presented as median with interquartile range. Comparisons between time points were made using Friedman’s test and the degree of correlation between two variables was expressed as Spearman’s rank correlation coefficient. RESULTS: Mean arterial pressure and cardiac index (CI) decreased and lactate concentration increased after induction of shock, and haemodynamics recovered after resuscitation. The flow density in the superficial retinal OCT angiogram decreased significantly after shock induction (baseline 44.7% (40.3; 50.5) vs haemorrhagic shock 34.5% (32.8; 40.4); P = 0.027) and recovered after fluid resuscitation (46.9% (41.7; 50.7) vs haemorrhagic shock; P = 0.027). The proportion of perfused vessels of the conjunctival microcirculation showed similar changes. The flow density measured using OCT-A correlated with the conjunctival microcirculation (perfused vessel density: Spearman’s rank correlation coefficient ρ = 0.750, P = 0.001) and haemodynamic parameters (CI: ρ = 0.693, P < 0.001). CONCLUSIONS: Retinal flow density, measured using OCT-A, significantly decreased in shock and recovered after fluid therapy in an experimental model of haemorrhagic shock. OCT-A is feasible to assess changes in retinal perfusion in haemorrhagic shock and fluid resuscitation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13054-018-2056-3) contains supplementary material, which is available to authorized users. BioMed Central 2018-05-29 /pmc/articles/PMC5975442/ /pubmed/29843760 http://dx.doi.org/10.1186/s13054-018-2056-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Alnawaiseh, Maged Ertmer, Christian Seidel, Laura Arnemann, Philip Helge Lahme, Larissa Kampmeier, Tim-Gerald Rehberg, Sebastian Willy Heiduschka, Peter Eter, Nicole Hessler, Michael Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock |
title | Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock |
title_full | Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock |
title_fullStr | Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock |
title_full_unstemmed | Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock |
title_short | Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock |
title_sort | feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5975442/ https://www.ncbi.nlm.nih.gov/pubmed/29843760 http://dx.doi.org/10.1186/s13054-018-2056-3 |
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