Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography Angiography
Transcatheter aortic valve implantation (TAVI) is an alternative to open heart surgery in the treatment of symptomatic aortic valve stenosis, which is often the treatment of choice in elderly and frail patients. It carries a risk of embolic complications in the whole cerebral vascular bed, which inc...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2021-12-01
|
Series: | Diagnostics |
Subjects: | |
Online Access: | https://www.mdpi.com/2075-4418/11/12/2399 |
_version_ | 1797505382177832960 |
---|---|
author | Jeanne Martine Gunzinger Burbuqe Ibrahimi Joel Baur Maximilian Robert Justus Wiest Marco Piccirelli Athina Pangalu Dominik Straumann Fabian Nietlispach Igal Moarof Sandrine Anne Zweifel |
author_facet | Jeanne Martine Gunzinger Burbuqe Ibrahimi Joel Baur Maximilian Robert Justus Wiest Marco Piccirelli Athina Pangalu Dominik Straumann Fabian Nietlispach Igal Moarof Sandrine Anne Zweifel |
author_sort | Jeanne Martine Gunzinger |
collection | DOAJ |
description | Transcatheter aortic valve implantation (TAVI) is an alternative to open heart surgery in the treatment of symptomatic aortic valve stenosis, which is often the treatment of choice in elderly and frail patients. It carries a risk of embolic complications in the whole cerebral vascular bed, which includes the retinal vasculature. The main objective was the evaluation of retinal emboli visible on optical coherence tomography angiography (OCTA) following TAVI. This is a prospective, single center, observational study enrolling consecutive patients over two years. Patients were assessed pre- and post-TAVI. Twenty-eight patients were included in the final analysis, 82.1% were male, median age was 79.5 (range 52–88), median BCVA was 82.5 letters (range 75–93). Eight patients (28.6%) presented new capillary dropout lesions in their post-TAVI OCTA scans. There was no statistically significant change in BCVA. Quantitative analysis of macular or peripapillary OCTA parameters did not show any statistically significant difference in pre- and post-intervention. In conclusion, capillary dropout lesions could frequently be found in patients after TAVI. Quantitative measurements of macular and peripapillary flow remained stable, possibly indicating effective ocular blood flow regulation within the range of left ventricular ejection fraction in our cohort. |
first_indexed | 2024-03-10T04:17:51Z |
format | Article |
id | doaj.art-371f8457a1944586a60f037e92973a6e |
institution | Directory Open Access Journal |
issn | 2075-4418 |
language | English |
last_indexed | 2024-03-10T04:17:51Z |
publishDate | 2021-12-01 |
publisher | MDPI AG |
record_format | Article |
series | Diagnostics |
spelling | doaj.art-371f8457a1944586a60f037e92973a6e2023-11-23T07:55:32ZengMDPI AGDiagnostics2075-44182021-12-011112239910.3390/diagnostics11122399Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography AngiographyJeanne Martine Gunzinger0Burbuqe Ibrahimi1Joel Baur2Maximilian Robert Justus Wiest3Marco Piccirelli4Athina Pangalu5Dominik Straumann6Fabian Nietlispach7Igal Moarof8Sandrine Anne Zweifel9Department of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Cardiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Information Technology and Electrical Engineering, ETH Zurich, 8092 Zurich, SwitzerlandDepartment of Neuroradiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Neurology, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Cardiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Cardiology, Kantonsspital Baden, 5404 Baden, SwitzerlandDepartment of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandTranscatheter aortic valve implantation (TAVI) is an alternative to open heart surgery in the treatment of symptomatic aortic valve stenosis, which is often the treatment of choice in elderly and frail patients. It carries a risk of embolic complications in the whole cerebral vascular bed, which includes the retinal vasculature. The main objective was the evaluation of retinal emboli visible on optical coherence tomography angiography (OCTA) following TAVI. This is a prospective, single center, observational study enrolling consecutive patients over two years. Patients were assessed pre- and post-TAVI. Twenty-eight patients were included in the final analysis, 82.1% were male, median age was 79.5 (range 52–88), median BCVA was 82.5 letters (range 75–93). Eight patients (28.6%) presented new capillary dropout lesions in their post-TAVI OCTA scans. There was no statistically significant change in BCVA. Quantitative analysis of macular or peripapillary OCTA parameters did not show any statistically significant difference in pre- and post-intervention. In conclusion, capillary dropout lesions could frequently be found in patients after TAVI. Quantitative measurements of macular and peripapillary flow remained stable, possibly indicating effective ocular blood flow regulation within the range of left ventricular ejection fraction in our cohort.https://www.mdpi.com/2075-4418/11/12/2399optical coherence tomography angiographyretinal embolitranscatheter aortic valve implantationOCTATAVI |
spellingShingle | Jeanne Martine Gunzinger Burbuqe Ibrahimi Joel Baur Maximilian Robert Justus Wiest Marco Piccirelli Athina Pangalu Dominik Straumann Fabian Nietlispach Igal Moarof Sandrine Anne Zweifel Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography Angiography Diagnostics optical coherence tomography angiography retinal emboli transcatheter aortic valve implantation OCTA TAVI |
title | Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography Angiography |
title_full | Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography Angiography |
title_fullStr | Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography Angiography |
title_full_unstemmed | Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography Angiography |
title_short | Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography Angiography |
title_sort | assessment of retinal capillary dropout after transcatheter aortic valve implantation by optical coherence tomography angiography |
topic | optical coherence tomography angiography retinal emboli transcatheter aortic valve implantation OCTA TAVI |
url | https://www.mdpi.com/2075-4418/11/12/2399 |
work_keys_str_mv | AT jeannemartinegunzinger assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography AT burbuqeibrahimi assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography AT joelbaur assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography AT maximilianrobertjustuswiest assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography AT marcopiccirelli assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography AT athinapangalu assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography AT dominikstraumann assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography AT fabiannietlispach assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography AT igalmoarof assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography AT sandrineannezweifel assessmentofretinalcapillarydropoutaftertranscatheteraorticvalveimplantationbyopticalcoherencetomographyangiography |