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非体外循环冠状动脉搭桥手术对黄斑中心凹下脉络膜厚度、神经节细胞复合体及视网膜神经纤维层厚度的影响。

The effect of off-pump coronary bypass graft surgery on subfoveal choroidal thickness, ganglion cell complex, and retinal nerve fiber layer thickness.

作者信息

Tıskaoğlu Nesime Setge, Yazıcı Alper, Ercan Abdulkadir, Tınç Kübra

机构信息

Ophthalmology Department, Dr. Ersin Arslan Research and Education Hospital, Eyüpoğlu, Hürriyet Cd. No: 40, Şahinbey/Gaziantep 27010, Turkey.

Ophthalmology Department, Batı Göz Hospital, Izmir, Turkey.

出版信息

Ther Adv Ophthalmol. 2023 Oct 11;15:25158414231204106. doi: 10.1177/25158414231204106. eCollection 2023 Jan-Dec.

Abstract

BACKGROUND

Cardiac surgery has been associated with adverse ocular events. Off-pump coronary artery bypass graft surgery evades the systemic inflammatory response seen in extracorporeal circulation and is superior to on-pump surgery with regard to end-organ dysfunction and neurological outcomes.

OBJECTIVES

To determine the effects of off-pump (without extracorporeal circulation) coronary artery bypass graft surgery on choroidal thickness, ganglion cell complex, and the retinal nerve fiber layer.

DESIGN

Prospective, longitudinal study.

METHODS

Patients who underwent off-pump surgery were examined preoperatively and postoperatively at 1 week and 6 weeks after surgery. Choroidal thickness, ganglion cell complex, and the retinal nerve fiber layer measurements were recorded, and the effects of off-pump coronary artery bypass on these parameters were assessed.

RESULTS

A total of 44 eyes of 44 patients were included in the study. There was a statistically significant increase in subfoveal choroidal thickness from 252.84 ± 56.24 µm preoperatively to 273.82 ± 39.76 µm at 1 week and 301.97 ± 44.83 µm at 6 weeks after off-pump coronary artery bypass graft surgery ( = 0.044;  ⩽ 0.001). Ganglion cell complex and retinal nerve fiber measurements showed no significant difference compared to preoperative values.

CONCLUSION

Off-pump coronary artery bypass graft surgery showed no negative effects on ganglion cell complex and retinal nerve fiber measurements. A significant increase in subfoveal choroidal thickness was seen after off-pump surgery, which might be advantageous in patients who are at high risk or have preexisting ocular diseases that are affected by the choroid.

摘要

背景

心脏手术与不良眼部事件有关。非体外循环冠状动脉搭桥手术可避免体外循环中出现的全身炎症反应,在器官功能障碍和神经学预后方面优于体外循环手术。

目的

确定非体外循环(无体外循环)冠状动脉搭桥手术对脉络膜厚度、神经节细胞复合体和视网膜神经纤维层的影响。

设计

前瞻性纵向研究。

方法

对接受非体外循环手术的患者在术前以及术后1周和6周进行检查。记录脉络膜厚度、神经节细胞复合体和视网膜神经纤维层的测量值,并评估非体外循环冠状动脉搭桥手术对这些参数的影响。

结果

本研究共纳入44例患者的44只眼。非体外循环冠状动脉搭桥手术后,黄斑中心凹下脉络膜厚度从术前的252.84±56.24μm显著增加至术后1周的273.82±39.76μm以及术后6周的301.97±44.83μm(P=0.044;P≤0.001)。神经节细胞复合体和视网膜神经纤维测量值与术前相比无显著差异。

结论

非体外循环冠状动脉搭桥手术对神经节细胞复合体和视网膜神经纤维测量值无负面影响。非体外循环手术后黄斑中心凹下脉络膜厚度显著增加,这对于高危患者或已有受脉络膜影响的眼部疾病患者可能是有利的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89e/10571675/f9ccb6bfc928/10.1177_25158414231204106-fig1.jpg

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