Transcatheter aortic valve replacement (TAVR) is associated with clinically significant cerebral microembolism and cognitive status changes. There are no data on the impact of TAVR on retinal layers. We assessed the influence of TAVR on the retinal nerve fiber layer, ganglion cell complex (GCC), and macular thickness (MT) measured by spectral domain optical coherence tomography (SD-OCT). Elderly patients (n = 50) with severe aortic stenosis undergoing TAVR were included in this study (mean age: 78.5 ± 6.9 years). Retinal nerve fiber layer, GCC, and MT were measured with SD-OCT by an ophthalmologist before and on the first day and in the first month after TAVR. The average MT was significantly increased on the first day after TAVR compared with the basal value (P = .04). Ganglion cell complex thickness was significantly thinner on the first day after TAVR than the basal value in the inner inferior quadrant and outer temporal quadrant of the left eye (P = .03 and .04, respectively). Postoperative changes observed on the first day compared with the preoperative period returned to basal values in the first month. In conclusion, TAVR did not cause permanent changes in retinal layers.
LindmanBRBonowROOttoCM. Current management of calcific aortic stenosis. Circ Res. 2013;113:223–37.
2.
BonowROGreenlandP. Population-wide trends in aortic stenosis incidence and outcomes. Circulation. 2015;131:969–71.
3.
KapadiaSRLeonMB, Makkar RR, et al. 5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet. 2015;385:2485–91.
4.
LeonMBSmithCRMackMJ, et al.Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Eng J Med. 2016;374:1609–20.
5.
LiewGWangJJMitchellPWongTY. Retinal vascular imaging: a new tool in microvascular disease research. Circ Cardiovasc Imaging. 2008;1:156–61.
6.
LamparterJSchmidtmannISchusterAK, et al.Association of ocular, cardiovascular, morphometric and lifestyle parameters with retinal nerve fibre layer thickness. PLoS One. 2018;13:e0197682.
7.
AkayFGundoganFCYolcuUToyranSTuncEUzunS. Retinal structural changes in systemic arterial hypertension: an OCT study. Eur J Ophthalmol. 2016;26:436–41.
8.
PekelGKilicIDAlihanogluYI, et al.Effects of coronary artery bypass grafting surgery on retinal vascular caliber, ocular pulse amplitude and retinal thickness measurements. Perfusion. 2015;30:312–17.
9.
AdNHolmesSDPatelJPritchardGShumanDJHalpinL. Comparison of EuroSCORE II, original EuroSCORE, and the society of thoracic surgeons risk score in cardiac surgery patients. Ann Cardiothorac Surg. 2016;102:573–79.
10.
NuisRJVan MieghemNMSchultzCJ, et al.Frequency and causes of stroke during or after transcatheter aortic valve implantation. Am J Cardiol. 2012;109:1637–43.
11.
Rodes-CabauJDumontEBooneRH, et al.Cerebral embolism following transcatheter aortic valve implantation: comparison of transfemoral and transapical approaches. J Am Coll Cardiol. 2011;57:18–28.
12.
SackSKahlertPKhandanpourS, et al.Revival of an old method with new techniques: balloon aortic valvuloplasty of the calcified aortic stenosis in the elderly. Clin Res Cardiol. 2008;97:288–97.
13.
SelleAFigullaHRFerrariM, et al.Impact of rapid ventricular pacing during TAVI on microvascular tissue perfusion. Clin Res Cardiol. 2014;103:902–11.
14.
BrodtJVladinovGCastillo-PedrazaCCooperLMarateaE. Changes in cerebral oxygen saturation during transcatheter aortic valve replacement. J Clin Monit Comput. 2016;30:649–53.
15.
PournarasCJRungger-BrandleERivaCEHardarsonSHStefanssonE. Regulation of retinal blood flow in health and disease. Prog Retin Eye Res. 2008;27:284–330.
16.
SousaDCLealIMoreiraSDionisioPAbegao PintoLMarques-NevesC. Hypoxia challenge test and retinal circulation changes - a study using ocular coherence tomography angiography. Acta Ophthalmologica. 2018;96:e315–e9.
17.
KozobolisVPDetorakisETGeorgiadisGSAchtaropoulosAAPapasTTLazaridesMK. Perimetric and retrobulbar blood flow changes following carotid endarterectomy. Graefes Arch Clin Exp Ophthalmol. 2007;245:1639–45.
18.
KeunenRWEikelboomBCStegemanDFAckerstaffRG. Chronic cerebral hypotension induces a downward shift of the cerebral autoregulation: a hypothesis based on TCD and OPG-GEE studies in ambulatory patients with occlusive cerebrovascular disease. Neurol Res. 1994;16:413–16.
19.
PradaDHarrisAGuidoboniGSieskyBHuangAMArcieroJ. Autoregulation and neurovascular coupling in the optic nerve head. Surv Ophthalmol. 2016;61:164–86.
20.
NeufeldAHKawaiSDasS, et al.Loss of retinal ganglion cells following retinal ischemia: the role of inducible nitric oxide synthase. Exp Eye Res. 2002;75:521–28.
21.
CameronJRMegawRDTathamAJ, et al.Lateral thinking-Interocular symmetry and asymmetry in neurovascular patterning, in health and disease. Prog Retin Eye Res. 2017;59:131–57.
22.
WongACChanCWHuiSP. Relationship of gender, body mass index, and axial length with central retinal thickness using optical coherence tomography. Eye (Lond). 2005;19:292–97.
23.
Selles-NavarroIVillegas-PerezMPSalvador-SilvaMRuiz-GomezJMVidal-SanzM.Retinal ganglion cell death after different transient periods of pressure-induced ischemia and survival intervals. A quantitative in vivo study. Invest Ophthalmol Vis Sci. 1996;37:2002–14.
24.
KinnRMBreisblattWM. Cortical blindness after coronary angiography: a rare but reversible complication. Cathet Cardiovasc Diagn. 1991;22:177–79.
25.
GellenBRempTMayerTMilzPFranzWM. Cortical blindness: a rare but dramatic complication following coronary angiography. Cardiology. 2003;99:57–59.
Fusi-RubianoWJYangYCSmallwoodAF, et al.Retinal embolic events: frequency and impact following transcatheter aortic valve implantation (TAVI) for aortic stenosis. BMJ Open Ophthalmol. 2017;1:e000033.
28.
KojuriJMehdizadehMRostamiHShahidianD. Clinical significance of retinal emboli during diagnostic and therapeutic cardiac catheterization in patients with coronary artery disease. BMC Cardiovasc Disord. 2011;11:5.
29.
DesatnikHQuigleyHAGlovinskyY. Study of central retinal ganglion cell loss in experimental glaucoma in monkey eyes. J Glaucoma. 1996;5:46–53.
30.
ZeimerRAsraniSZouSQuigleyHJampelH.Quantitative detection of glaucomatous damage at the posterior pole by retinal thickness mapping. A pilot study. Ophthalmology. 1998;105:224–31.
31.
RimayantiULatiefMAArintawatiPAkitaTTanakaJKiuchiY. Width of abnormal ganglion cell complex area determined using optical coherence tomography to predict glaucoma. Jpn J Ophthalmol. 2014;58:47–55.
32.
WeinrebRNAungTMedeirosFA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311:1901–11.
33.
KaurCFouldsWSLingEA. Blood-retinal barrier in hypoxic ischaemic conditions: basic concepts, clinical features and management. Prog Retin Eye Res. 2008;27:622–47.
34.
EertmansWGenbruggeCFretT, et al.Influence of continuously evolving transcatheter aortic valve implantation technology on cerebral oxygenation. J Clin Monit Comput. 2017;31:1133–41.
