gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Can you see it? Retinal vessel analysis (RVA) for cerebral vasospasm – A prospective pilot study

Meeting Abstract

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  • Walid Albanna - Department of Neurosurgery, RWTH Aachen University, Germany
  • Catharina Conzen - Department of Neurosurgery, RWTH Aachen University, Germany
  • Miriam Weiss - Department of Neurosurgery, RWTH Aachen University, Germany
  • Hans Clusmann - Department of Neurosurgery, RWTH Aachen University, Germany
  • Matthias Fuest - Department of Ophthalmology, RWTH Aachen University, Germany
  • Marguerite Mueller - Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Germany
  • Marc Alexander Brockmann - Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Germany
  • Walthard Vilser - IMEDOS Systems UG, Jena, Germany
  • Arno Schmidt-Trucksäss - Department of Exercise and Health Sciences, University of Basel, Switzerland
  • Anke Hoellig - Department of Neurosurgery, RWTH Aachen University, Germany
  • Marcel Seiz - Department of Neurosurgery, Universitätsmedizin Mannheim, University of Heidelberg, Germany
  • Claudius Thomé - Department of Neurosurgery, Medical University Innsbruck, Austria
  • Konstantin Kotliar - Department of Medical Engineering and Technomathematics, FH Aachen University of Applied Sciences, Germany
  • Gerrit Alexander Schubert - Department of Neurosurgery, RWTH Aachen University, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.18.08

doi: 10.3205/16dgnc212, urn:nbn:de:0183-16dgnc2129

Published: June 8, 2016

© 2016 Albanna et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Timely detection of impending delayed cerebral ischemia after subarachnoid hemorrhage (SAH) is essential to improve outcome, but poses a diagnostic challenge. Retinal vessels as an embryological part of the intracranial vasculatur are easily accessible for analysis and may hold the key to a new and non-invasive monitoring technique. This investigation aims to determine the feasibility of standardized retinal vessel analysis (RVA) in the context of SAH.

Method: In a prospective pilot study, we performed RVA in six patients with SAH in the acute phase and eight patients at the time of follow-up, and included 33 age-matched healthy controls. Data was acquired using a manoeuvrable Dynamic Vessel Analyzer (Imedos Systems UG, Jena) for examination of retinal vessel dimension and autoregulation.

Results: Image quality was satisfactory in the majority of cases (93.3%). In the acute phase after SAH, retinal arteries were significantly dilated when compared to the control group (124.2±4.3MU vs 110.9±11.4MU, p<0.01), a difference that persisted to a lesser extent in the later stage of the disease (122.7±17.2MU, p<0.05). Autoregulatory capacity showed a trend towards impaired primary vasodilation and secondary vasoconstriction (p=0.08, p=0.09 resp.) initially and partial recovery at the time of follow-up, indicating a relative improvement in a time-dependent fashion.

Conclusions: RVA is technically feasible in patients with SAH and can detect fluctuations in vessel diameter and autoregulation. Preliminary data suggests potential for RVA as a new and non-invasive tool for advanced SAH monitoring, but clinical relevance and prognostic value will have to be determined in a larger cohort.