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Ocular blood flow by laser speckle flowgraphy to detect cerebral ischemia during carotid endarterectomy

DOI:10.1007/s10877-020-00475-1 期刊:Journal of Clinical Monitoring and Computing 出版年份:2020 更新时间:2025-09-23 15:19:57
摘要: Laser speckle flowgraphy (LSFG) is a noninvasive technique that can measure relative blood flow velocity in the optic fundus contributed by the ophthalmic artery, the main first branch originating from the internal carotid artery (ICA). The aim of this study was to assess the feasibility of ocular blood flow measurement by LSFG to detect ischemic stress due to carotid clamping during carotid endarterectomy (CEA). Nineteen patients undergoing CEA with ocular blood flow measurement by LSFG and intraoperative monitoring (IOM) were prospectively enrolled between August 2016 and March 2019. The mean blur rate (MBR) of ocular blood flow by LSFG, representing relative blood flow of the branch of the retinal artery originating from the optic nerve head, was compared between before and after carotid clamping during CEA. The correlation between the reduction ratio of MBR and the regional saturation oxygen (rSO2) index by near infrared spectroscopy was investigated. Ocular blood flow measurement by LSFG could not be performed in one patient with a severe cataract. In the other 18 patients, LSFG could be performed in all 106 sessions during surgery. The MBR reduction ratio between before and after carotid clamping ranged from ? 12 to 100%. The MBR reduction ratio was positively correlated with the rSO2 index (r = 0.694, 95% confidence interval: 0.336–0.877, p = 0.001). The MBR reduction ratio of ocular blood flow by LSFG after carotid clamping was significantly correlated with the rSO2 index. The ocular blood flow by LSFG could be considered an adjunct modality for evaluating cerebral ischemic tolerance during CEA.
作者: Yasushi Motoyama,Yoshiaki Takamura,Masashi Kotsugi,Taekyun Kim,Shuichi Yamada,Ichiro Nakagawa,Young-Su Park,Masahiko Kawaguchi,Hiroyuki Nakase,Hironobu Hayashi,Hideaki Kawanishi,Kohsuke Tsubaki,Tsunenori Takatani
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To assess the feasibility of ocular blood flow measurement by LSFG to detect ischemic stress due to carotid clamping during carotid endarterectomy (CEA).

The reduction ratio of MBR of ocular blood flow by LSFG due to carotid clamping was significantly correlated with rSO2 index change. The ocular blood flow by LSFG could be considered an adjunct modality for evaluating cerebral ischemic tolerance during CEA.

1. Continuous measurement of ocular blood flow using LSFG carries the risk of corneal damage by continuing to maintain an open eyelid. 2. It is difficult to obtain accurate data of ocular blood flow using LSFG in patients with a severe cataract. 3. Small sample size.

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