The Effect of Off-pump Coronary Bypass Graft Surgery on Subfoveal Choroidal Thickness, Ganglion Cell Complex, and Retinal Nerve Fiber Layer Thickness

Overview

Journal Ther Adv Ophthalmol

Specialty Ophthalmology

Date 2023 Oct 16

PMID 37841646

Authors

Nesime Setge Tiskaoglu

Alper Yazici

Abdulkadir Ercan

Kubra Tinc

Affiliations

Soon will be listed here.

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.

References

Kuroda S, Ikuno Y, Yasuno Y, Nakai K, Usui S, Sawa M . Choroidal thickness in central serous chorioretinopathy. Retina. 2012; 33(2):302-8. DOI: 10.1097/IAE.0b013e318263d11f. View

Delaey C, Van de Voorde J . Regulatory mechanisms in the retinal and choroidal circulation. Ophthalmic Res. 2000; 32(6):249-56. DOI: 10.1159/000055622. View

Farazdaghi M, Ebrahimi K . Role of the Choroid in Age-related Macular Degeneration: A Current Review. J Ophthalmic Vis Res. 2019; 14(1):78-87. PMC: 6388521. DOI: 10.4103/jovr.jovr_125_18. View

Balikci A, Yener N, Seferoglu M . Optical Coherence Tomography and Optical Coherence Tomography Angiography Findings in Multiple Sclerosis Patients. Neuroophthalmology. 2022; 46(1):19-33. PMC: 8794252. DOI: 10.1080/01658107.2021.1963787. View

Melek F, Baroncini L, Repka J, Nascimento C, Precoma D . Oxidative stress and inflammatory response increase during coronary artery bypass grafting with extracorporeal circulation. Rev Bras Cir Cardiovasc. 2012; 27(1):61-5. DOI: 10.5935/1678-9741.20120010. View

Li S, Fu Z, Lo A . Hypoxia-induced oxidative stress in ischemic retinopathy. Oxid Med Cell Longev. 2012; 2012:426769. PMC: 3483772. DOI: 10.1155/2012/426769. View

Manjunath V, Goren J, Fujimoto J, Duker J . Analysis of choroidal thickness in age-related macular degeneration using spectral-domain optical coherence tomography. Am J Ophthalmol. 2011; 152(4):663-8. PMC: 3375176. DOI: 10.1016/j.ajo.2011.03.008. View

Gaudric A, Coscas G, Bird A . Choroidal ischemia. Am J Ophthalmol. 1982; 94(4):489-98. DOI: 10.1016/0002-9394(82)90242-2. View

Pekel G, Alur I, Alihanoglu Y, Yagci R, Emrecan B . Choroidal changes after cardiopulmonary bypass. Perfusion. 2014; 29(6):560-6. DOI: 10.1177/0267659114529324. View

10.

Khan M, Islam M, Ahmed M, Bawany F, Khan A, Hussham Arshad M . On pump coronary artery bypass graft surgery versus off pump coronary artery bypass graft surgery: a review. Glob J Health Sci. 2014; 6(3):186-93. PMC: 4825227. DOI: 10.5539/gjhs.v6n3p186. View

11.

Dominici C, Salsano A, Nenna A, Spadaccio C, El-Dean Z, Bashir M . Neurological outcomes after on-pump vs off-pump CABG in patients with cerebrovascular disease. J Card Surg. 2019; 34(10):941-947. DOI: 10.1111/jocs.14158. View

12.

Dulku S . Generating a random sequence of left and right eyes for ophthalmic research. Invest Ophthalmol Vis Sci. 2012; 53(10):6301-2. DOI: 10.1167/iovs.12-10737. View

13.

Pekel G, Kilic I, Alihanoglu Y, Acer S, Yagci R, Kaya H . Effects of coronary artery bypass grafting surgery on retinal vascular caliber, ocular pulse amplitude and retinal thickness measurements. Perfusion. 2014; 30(4):312-7. DOI: 10.1177/0267659114547249. View

14.

Bayar S, Ozturker Z, Yaman Pinarci E, Ercan Z, Akay H, Yilmaz G . Structural Analysis of the Retina and Choroid before and after Carotid Artery Surgery. Curr Eye Res. 2019; 45(4):496-503. DOI: 10.1080/02713683.2019.1666994. View

15.

Lee J, Lee D, Lee J, Yoon Y . Correlation between subfoveal choroidal thickness and the severity or progression of nonexudative age-related macular degeneration. Invest Ophthalmol Vis Sci. 2013; 54(12):7812-8. DOI: 10.1167/iovs.13-12284. View

16.

Lin T, Vitkova V, Asseyer S, Martorell Serra I, Motamedi S, Chien C . Increased Serum Neurofilament Light and Thin Ganglion Cell-Inner Plexiform Layer Are Additive Risk Factors for Disease Activity in Early Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm. 2021; 8(5). PMC: 8362351. DOI: 10.1212/NXI.0000000000001051. View

17.

Struber M, Cremer J, Gohrbandt B, Hagl C, Jankowski M, Volker B . Human cytokine responses to coronary artery bypass grafting with and without cardiopulmonary bypass. Ann Thorac Surg. 1999; 68(4):1330-5. DOI: 10.1016/s0003-4975(99)00729-8. View

18.

Bill A, Sperber G . Control of retinal and choroidal blood flow. Eye (Lond). 1990; 4 ( Pt 2):319-25. DOI: 10.1038/eye.1990.43. View

19.

Bhattacharya S . Outcomes of off-pump coronary artery bypass grafting in non-dialysis-dependent patients with stage 2 and stage 3 chronic kidney disease. Indian J Thorac Cardiovasc Surg. 2021; 37(4):392-401. PMC: 8218098. DOI: 10.1007/s12055-020-01132-7. View

20.

Ameen Ismail A, Tolba H, Sadek S, Hatata R . Purtscher-like retinopathy following coronary artery bypass grafting in an antiphospholipid syndrome patient: a case report. BMC Ophthalmol. 2023; 23(1):197. PMC: 10157585. DOI: 10.1186/s12886-023-02935-z. View