Retinal blood flow in critical illness and systemic disease: a review.

Courtie, E, Veenith, Tonny, Logan, A, Denniston, A K and Blanch, R J (2020) Retinal blood flow in critical illness and systemic disease: a review. Annals of intensive care, 10 (1). p. 152. ISSN 2110-5820. Available through UHB Open Athens

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Assessment and maintenance of end-organ perfusion are key to resuscitation in critical illness, although there are limited direct methods or proxy measures to assess cerebral perfusion. Novel non-invasive methods of monitoring microcirculation in critically ill patients offer the potential for real-time updates to improve patient outcomes.


Parallel mechanisms autoregulate retinal and cerebral microcirculation to maintain blood flow to meet metabolic demands across a range of perfusion pressures. Cerebral blood flow (CBF) is reduced and autoregulation impaired in sepsis, but current methods to image CBF do not reproducibly assess the microcirculation. Peripheral microcirculatory blood flow may be imaged in sublingual and conjunctival mucosa and is impaired in sepsis. Retinal microcirculation can be directly imaged by optical coherence tomography angiography (OCTA) during perfusion-deficit states such as sepsis, and other systemic haemodynamic disturbances such as acute coronary syndrome, and systemic inflammatory conditions such as inflammatory bowel disease.


Monitoring microcirculatory flow offers the potential to enhance monitoring in the care of critically ill patients, and imaging retinal blood flow during critical illness offers a potential biomarker for cerebral microcirculatory perfusion.

Item Type: Article
Additional Information: Available through UHB Open Athens
Subjects: WB Practice of medicine > WB400 Intensive care
WW Eyes. Ophthalmology
Divisions: Ambulatory Care > Ophthalmology
Clinical Support > Critical Care
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Depositing User: Beth Connors
Date Deposited: 26 Nov 2020 15:52
Last Modified: 26 Nov 2020 15:52

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