REDUCED PATHOLOGICAL RETINAL FINDINGS AFT ER PORTOSYSTEMIC SHUNTING PROCEDURE IN CIRRHOTIC-PATIENTS

Background: In patients with advanced cirrhosis and portal hypertensio n a portosystemic shunting procedure is often necessary. This induces haemodynamic changes in the systemic circulation. The aim of this stud y was to find out whether there were changes in the retinal perfusion as well. Methods and patients: 17 patients with mainly ethyl-toxic cir rhosis (13 male, 4 female; mean age 54 years, range 34-72 years) under went ophthalmologic examination before and 3 months after TIPS (transj ugular intrahepatic portosystemic stent shunt). Results: Before TIPS t here were pathological findings in 11 patients: In five cases cottonwo ol spots, in three cases discrete vessel abnormalities, in two cases s mall intraretinal haemorrhages and in one case papilloedema. In all ca ses these pathological findings were similar in both eyes. Three month s after TIPS all these changes had completely disappeared or were at l east considerably declining. Conclusions: The pathological findings in patients with advanced cirrhosis were interpreted as signs of reduced retinal perfusion. After a portosystemic shunting procedure signs of recovery were seen.