Conjunctival blood flow during cardiac surgery
Research type
Research Study
Full title
Conjunctival blood flow in patients undergoing cardiac surgery
IRAS ID
169916
Contact name
Prakash Punjabi
Contact email
Sponsor organisation
Joint Research Compliance Office, Imperial College London
Duration of Study in the UK
0 years, 1 months, 24 days
Research summary
Coronary artery bypass surgery may initiate a systemic inflammatory response (OHRI et al 1996). Which may induce damage to the splanchnic bed due in part to hypoperfusion. This may also lead to the development of emboli due to the inflammatory response which has been demonstrated in both retinal fluorescein angiograms (BLAUTH et al 1988) and video recording during experimental conditions in dogs. Video recording using indocyanine green angiography during neurosurgery shows a similar appearance to that of retinal fluorescein angiography during cardiopulmonary bypass (CPB). An inflammatory response has been shown in experimental conditions in the mesentery of the rat. Leukocyte activation is known to be a component of the inflammatory response.
Retinal fluorescein angiography has demonstrated the effect of emboli during CPB (BLAUTH et al). The retina is served by the short posterior cilliary arteries which rise from the ophthalmic artery. Both the retina and the brain derive their blood supply from the internal carotid artery therefore it is assumed that the changes that occur in the retina during CPB are also likely to occur in the cerebral circulation.
The conjunctiva is a vascular mucosal bed similar to the mesentery and since the changes that occur in the mesentery during CBP are systemic, it is reasonable to assume that these changes will be demonstrated in the conjunctiva.GAYNES et al 2012 used a slit lamp microscope to evaluate conjunctival blood flow in rabbits and to measure vessel diameter and suggest this may be used to evaluate cardiovascular function. (NGUYEN et al 2004) observed rolling of leukocytes in conjunctival vessels. (BABA et al 2004) developed a method to observe and record blood flow in the conjunctiva during the implantation of an artificial heart in the goat and detected changes between pulsatile and non pulsatile perfusion.
REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
15/LO/0702
Date of REC Opinion
14 Apr 2015
REC opinion
Favourable Opinion