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Ocular blood flow by laser speckle flowgraphy to detect cerebral ischemia during carotid endarterectomy
摘要： Laser speckle flowgraphy (LSFG) is a noninvasive technique that can measure relative blood flow velocity in the optic fundus contributed by the ophthalmic artery, the main first branch originating from the internal carotid artery (ICA). The aim of this study was to assess the feasibility of ocular blood flow measurement by LSFG to detect ischemic stress due to carotid clamping during carotid endarterectomy (CEA). Nineteen patients undergoing CEA with ocular blood flow measurement by LSFG and intraoperative monitoring (IOM) were prospectively enrolled between August 2016 and March 2019. The mean blur rate (MBR) of ocular blood flow by LSFG, representing relative blood flow of the branch of the retinal artery originating from the optic nerve head, was compared between before and after carotid clamping during CEA. The correlation between the reduction ratio of MBR and the regional saturation oxygen (rSO2) index by near infrared spectroscopy was investigated. Ocular blood flow measurement by LSFG could not be performed in one patient with a severe cataract. In the other 18 patients, LSFG could be performed in all 106 sessions during surgery. The MBR reduction ratio between before and after carotid clamping ranged from ? 12 to 100%. The MBR reduction ratio was positively correlated with the rSO2 index (r = 0.694, 95% confidence interval: 0.336–0.877, p = 0.001). The MBR reduction ratio of ocular blood flow by LSFG after carotid clamping was significantly correlated with the rSO2 index. The ocular blood flow by LSFG could be considered an adjunct modality for evaluating cerebral ischemic tolerance during CEA.
关键词： Ocular blood flow,Laser speckle flowgraphy,Cerebral blood flow,Carotid endarterectomy
更新于2025-09-23 15:19:57
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Pulse Waveform Analysis of the Ocular Blood Flow Using Laser Speckle Flowgraphy before and after Glaucoma Treatment
摘要： Although reduction in intraocular pressure (IOP) is the principle of glaucoma treatment, impaired ocular blood ?ow is believed to play a role in the progression of glaucoma. This study evaluated the e?ect of glaucoma treatment on pulse waveforms for optic nerve head (ONH) microcirculation in patients with glaucoma. Fifty-one subjects were included on the basis of the glaucoma treatment administered, which involved instillation of prostaglandin (PG) analogs (PG group; n ? 28) or trabeculectomy (trabeculectomy group; n ? 23). ONH blood ?ow, represented by the mean blur rate (MBRT) and pulse waveforms, was measured using laser speckle ?owgraphy before and 1 and 3 months after treatment. Three months after treatment, IOP exhibited a signi?cant decrease (p < 0.05). Although there was no signi?cant change in MBRT after treatment, the acceleration time index (ATI) signi?cantly decreased (p ? 0.034) in the PG group. In the trabeculectomy group, there was no signi?cant change in the MBRT after treatment, while ?uctuation (p ? 0.019) and blowout score (BOS) (p ? 0.036) exhibited signi?cant decrease and increase, respectively. Multiple regression analysis showed that mean deviation was signi?cantly associated with the rate of change in the BOS (p ? 0.013), age was a signi?cant contributing factor for the rate of change in ?uctuation in the trabeculectomy group, re?ection was signi?cantly associated with the ATI (p ? 0.037) in the in the PG group. Both glaucoma treatments can change the pulse waveforms, with MBRT remaining unchanged, and IOP reduction owing to the treatment may contribute to stable blood ?ow in the tissue area of the ONH. As impaired ocular blood ?ow plays a role in the progression of glaucomatous damage, it would be bene?cial if glaucoma treatment could improve the stability of ONH microcirculation.
关键词： prostaglandin analogs,laser speckle flowgraphy,trabeculectomy,intraocular pressure,glaucoma,ocular blood flow
更新于2025-09-12 10:27:22