Shahriari M, Nikkhah H, Mahjoob MP, Behnaz N, Barkhordari S, Cheraqpour K. Impact of coronary artery bypass grafting surgery on the chorioretinal biomicroscopic characteristics. World J Clin Cases 2023; 11(28): 6754-6762 [PMID: 37901009 DOI: 10.12998/wjcc.v11.i28.6754]
Corresponding Author of This Article
Homayoun Nikkhah, MD, Academic Research, Chief Physician, Research Scientist, Researcher, Department of Ophthalmology, Torfe Medical Center, Baharestan Square, Ebne Sina Street, Tehran 1149847514, Iran. h.nikkhah52@gmail.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mansoor Shahriari, Shahriar Barkhordari, Department of Ophthalmology, Imam Hossein Educational Hospital, Tehran 1617763141, Iran
Homayoun Nikkhah, Department of Ophthalmology, Torfe Medical Center, Tehran 1149847514, Iran
Mohammad Parsa Mahjoob, Cardiovascular Diseases, Imam Hossein Educational Hospital, Tehran 1617763141, Iran
Nazanin Behnaz, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran 1617763141, Iran
Kasra Cheraqpour, Department of Ophthalmology, Farabi Eye Hospital, Tehran 1336616351, Iran
Author contributions: Shahriari M, Nikkhah H, and Mahjoob MP conceived and designed the research; Behnaz N, Barkhordari S, and Cheraqpour K collected the data and wrote the paper; and all authors have read and approved the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Ophthalmic Research Center, Shahid Beheshti university of Medical Sciences (Approval No. IR.SBMU.MSP.REC.1398.224).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: There is no additional data available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Homayoun Nikkhah, MD, Academic Research, Chief Physician, Research Scientist, Researcher, Department of Ophthalmology, Torfe Medical Center, Baharestan Square, Ebne Sina Street, Tehran 1149847514, Iran. h.nikkhah52@gmail.com
Received: May 22, 2023 Peer-review started: May 22, 2023 First decision: August 8, 2023 Revised: August 21, 2023 Accepted: August 25, 2023 Article in press: August 25, 2023 Published online: October 6, 2023 Processing time: 125 Days and 15.2 Hours
Abstract
BACKGROUND
Most patients with cardiovascular disorders suffer from coronary artery diseases, which can be treated successfully using coronary artery bypass grafting (CABG). One of the unpleasant events following CABG is postoperative vision loss (POVL). Vulnerability of retinal vessels to hemodynamic changes, an expectable event following CABG, may contribute to the development of POVL, which might be associated with the changes in the choroidal and retinal structures.
AIM
To investigate postoperative changes in chorioretinal and peripapillary nerve fiber layer (NFL) thickness, and progression of diabetic and hypertensive retinopathy after CABG.
METHODS
In this prospective, cross-sectional study, 49 eyes in 25 candidates for CABG underwent both ophthalmic and cardiovascular examinations within 6 mo prior to and 9 mo after surgery.
RESULTS
Among the study participants, 56% were male with a mean age of 62.84 years ± 10.49 years (range 33–80 years). Diabetes mellitus was observed in eight participants (32%). None of the patients suffered from postoperative anterior or posterior ischemic optic neuropathy, central retinal artery occlusion, and cortical blindness. The mean value of the preoperative best corrected visual acuity was 0.11 ± 0.10 logMAR (range, 0–0.4), which worsened to 0.15 ± 0.08 logMAR (range, 0–0.4) after CABG (P = 0.031). No significant difference was observed between the pre- and postsurgical choroidal (P = 0.853) and macular (P = 0.507) thickness, NFL thickness in the subfoveal (P > 0.999) and peripapillary areas (P = 0.659), as well as the severity of diabetic and hypertensive retinopathy.
CONCLUSION
CABG may reduce visual acuity without affecting ocular structures. Postoperative vision reduction might be attributable to molecular or cellular variations, changes in visual pathway function, or central nervous system.
Core Tip: This was a prospective cohort study investigating the effect of coronary artery bypass grafting (CABG) on the chorioretinal and peripapillary nerve fiber layer thicknesses, as well as the progression of diabetic and hypertensive retinopathy. CABG may significantly reduce the visual acuity without impacting on the ocular structures.
