This prospective observational study investigates the impact of pulsatile versus non-pulsatile cardiopulmonary bypass (CPB) flow on choroidal circulation in diabetic and non-diabetic patients undergoing elective coronary artery bypass grafting (CABG). A total of 104 patients aged 30 to 70 years will be included, with balanced distribution between diabetic and non-diabetic groups. Optical coherence tomography angiography (OCTA) will be performed preoperatively and at 1 month postoperatively to assess changes in choroidal vascularity. The primary objective is to determine whether the type of CPB flow affects choroidal microcirculation, particularly in diabetic patients. The findings may support more individualized perfusion strategies in patients at risk of ocular microvascular impairment.
Who can participate
Age range30 Years – 70 Years
SexALL
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Inclusion criteria
✓. Age between 30 and 70 years
✓. Undergoing elective, first-time coronary artery bypass graft surgery (CABG)
✓. Stable metabolic status
✓. For diabetic group: history of diabetes mellitus for more than 10 years
✓. No significant ocular media opacity (e.g., cataract or vitreous hemorrhage)
✓. No tremor or condition interfering with OCTA imaging
✓. Aortic cross-clamp time ≤ 120 minutes
Exclusion criteria
✕. Age \<30 or \>70 years
✕. Re-do or emergency cardiac surgery
✕. Diabetes duration \<10 years (for diabetic group)
✕. Unstable metabolic state or active infection
What they're measuring
1
Change in Choroidal Vascularity Index (CVI) from Baseline to 1-Month Postoperative