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Open Access 01-12-2018 | Research

Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock

Authors: Maged Alnawaiseh, Christian Ertmer, Laura Seidel, Philip Helge Arnemann, Larissa Lahme, Tim-Gerald Kampmeier, Sebastian Willy Rehberg, Peter Heiduschka, Nicole Eter, Michael Hessler

Published in: Critical Care | Issue 1/2018

Abstract

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.

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Title: Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock
Authors: Maged Alnawaiseh
Christian Ertmer
Laura Seidel
Philip Helge Arnemann
Larissa Lahme
Tim-Gerald Kampmeier
Sebastian Willy Rehberg
Peter Heiduschka
Nicole Eter
Michael Hessler
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2018
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-018-2056-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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