Optische Kohärenztomographie-Angiographie in der Intensivmedizin : Ein neues Einsatzgebiet?

Hessler M, Lehmann F, Arnemann P, Eter N, Ertmer C, Alnawaiseh M

Abstract

BACKGROUND Many critically ill patients show a~disturbance of the microcirculation, which is not yet regularly examined in the clinical routine; however, for treatment decisions and estimation of the prognosis it would be important to obtain detailed information about the microcirculation in critically ill patients. Optical coherence tomography angiography (OCTA) is a~non-invasive, contact-free technique, which enables visualization of the blood flow in the retinal microcirculation within a~few seconds. Therefore, it may have the potential to diagnose microcirculation disorders in critically ill patients. OBJECTIVE The aims of the study were to assess the importance of the microcirculation in intensive care medicine, a comparison of the methods of video microscopy and OCTA and analysis of preclinical and clinical data on the use of OCTA in intensive care medicine. MATERIAL AND METHODS A selective literature review and data analysis were carried out. RESULTS A direct visualization of the microcirculation has been possible for many years with the technique of video microscopy but this has not become established in the clinical routine due to the susceptibility to interferences and a~time-consuming manual analysis. The OCTA is a~non-invasive and contact-free method for the visualization of retinal blood flow. First preclinical data in septic and hemorrhagic shock show good results of OCTA for analysis of the microcirculation. CONCLUSION The non-invasive technique of OCTA is a~promising measurement method to enable bedside analysis of the microcirculation in critically ill paients in the future; however, some technical limitations must still be overcome.