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The Eye as a Non-Invasive Window to the Microcirculation in Liver Cirrhosis: A Prospective Pilot Study
- 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.
- Subjects :
- medicine.medical_specialty
Cirrhosis
genetic structures
medicine.medical_treatment
lcsh:Medicine
microcirculation
030204 cardiovascular system & hematology
Liver transplantation
Microcirculation
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Internal medicine
renal dysfunction
medicine
Endothelial dysfunction
Retina
optical coherence tomography
business.industry
Communication
cirrhosis
lcsh:R
Retinal
General Medicine
medicine.disease
eye diseases
Transplantation
medicine.anatomical_structure
chemistry
Cardiology
030211 gastroenterology & hepatology
sense organs
business
Kidney disease
Subjects
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