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The Eye as a Non-Invasive Window to the Microcirculation in Liver Cirrhosis: A Prospective Pilot Study

Authors :
Kirstie Hetherington
Fiona J. Gifford
Jonathan A. Fallowfield
Francesca Moroni
Tom MacGillivray
Peter C. Hayes
Tariq E. Farrah
Neeraj Dhaun
Source :
Journal of Clinical Medicine, Journal of Clinical Medicine, Vol 9, Iss 3332, p 3332 (2020), Gifford, F, Moroni, F, Farrah, T, Hetherington, K, MacGillivray, T, Hayes, P C, Dhaun, N & Fallowfield, J A 2020, ' The eye as a non-invasive window to the microcirculation in liver cirrhosis: a prospective pilot study ', Journal of Clinical Medicine . https://doi.org/10.3390/jcm9103332
Publication Year :
2020
Publisher :
MDPI, 2020.

Abstract

Microcirculatory dysfunction is associated with organ failure, poor response to vasoactive drugs and increased mortality in cirrhosis, but monitoring techniques are not established. We hypothesized that the chorioretinal structures of the eye could be visualized as a non-invasive proxy of the systemic microvasculature in cirrhosis and would correlate with renal dysfunction. Optical Coherence Tomography (OCT) was performed to image the retina in n = 55 cirrhosis patients being assessed for liver transplantation. OCT parameters were compared with established cohorts of age- and sex-matched healthy volunteers (HV) and patients with chronic kidney disease (CKD). Retinal thickness, macular volume and choroidal thickness were significantly reduced relative to HV and comparable to CKD patients (macular volume: HV vs. cirrhosis mean difference 0.44 mm3 (95% CI 0.26–0.61), p ≤ 0.0001). Reduced retinal thickness and macular volume correlated with renal dysfunction in cirrhosis (macular volume vs. MDRD-6 eGFR r = 0.40, p = 0.006). Retinal changes had resolved substantially 6 weeks following transplantation. There was an inverse association between choroidal thickness and circulating markers of endothelial dysfunction (endothelin-1 r = −0.49, p ≤ 0.001; von Willebrand factor r = −0.32, p ≤ 0.05). Retinal OCT may represent a non-invasive window to the microcirculation in cirrhosis and a dynamic measure of renal and endothelial dysfunction. Validation in different cirrhosis populations is now required.

Details

Language :
English
ISSN :
20770383
Volume :
9
Issue :
10
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine
Accession number :
edsair.doi.dedup.....86426bd2644998a27870c049e8a69ea0
Full Text :
https://doi.org/10.3390/jcm9103332