Visual Function Markers in Cardiac Surgery-Impact of Fundus Fluorescein Angiography in Assessing Ocular Circulation

Author(s): Vasiliki Trantou, Dimitrios V Moysidis, Rodopi Stamatiou, Andreas S Papazoglou, Maria Kotoula, Isaac Aidonidis, Ioannis Skoularigis, Nikolaos Tsilimingas, Tsironi Evangelia

Objectives: Cardiac surgery has been reported to be associated, albeit rarely, with postoperative vision alterations up to vision loss. In this study, we sought to examine if patients undergoing on-pump cardiac surgery are at higher risk for developing deranged vision based on analysis of standard visual parameters.

Methods: A total of 88 patients, who underwent coronary artery bypass graft (CABG, n=56) or aortic valve replacement (AVR, n=32) surgery were initially enrolled in our study in order to assess their visual function, right before and one month after surgery. The following examinations were performed: Visual Acquity (VA), Intraocular Pressure (IOP), Fundus Fluorescein Angiography Time (FFAT), and Optical Coherence Tomography (OCT). The collected data were statistically analysed by performing Mann Witney U Test in SPSS (CI=95%).

Results: One out of 88 patients (1.13%) showing complete vision loss after valvular surgery was excluded from study. From the remaining patients, 60 (69%) showed a decrease in the postoperative FFAT, while in 27 (31%) FFAT was increased. FFATs were improved in more patients with AVR (74%) than in those with CABG (66%) (p<0.05). Patients with extracorporeal circulation (ECC) time <90 min displayed improvement in FFAT, whereas those with ECC times >101 min had worser post- vs preoperative FFATs (38 vs 56%, respectively). No significant differences were observed in VA, IOP, OCT findings between the CABG and AVR group.

Conclusions: The vast majority of patients did not have any vision complications after surgery. They showed shorter FFATs post- vs preoperatively, implicating improved retinal flow. FFAT seemed to be dependent, at least partially, on the ECC time and possibly the type of operation.

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