Orbital Doppler evaluation of blood flow velocities in patients with diabetic retinopathy.
Orbital Doppler evaluation of blood flow velocities in patients with diabetic retinopathy.
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DOI：
10.1900/rds.2012.9.104
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发表时间：
2012-06-01
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影响因子：
--
通讯作者：
Kaviani, Ahmad
中科院分区：
文献类型：
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作者：
Karami, Mehdi;Janghorbani, Mohsen;Kaviani, Ahmad
背景：关于糖尿病视网膜病变（DR）患者眼眶血管受损的眼部血流动力学，存在相互矛盾的结果。迫切需要澄清糖尿病患者视网膜病变的早期症状。目的：我们的目的是使用多普勒和灰阶超声检查评估 DR 患者的眼眶血流速度，并将结果与非糖尿病和无视网膜病变的糖尿病同龄人进行比较。方法：对 123 名 29-77 岁的患者进行眼眶多普勒和灰阶超声检查，这些患者被分为 3 组：非糖尿病对照 (n = 25)、糖尿病和糖耐量受损伴轻微临床视网膜病变 (n = 74) 以及糖尿病伴未经治疗的非增殖性视网膜病变 (n = 24)。眼科医生根据眼底镜检查诊断出视网膜病变。测量眼动脉、视网膜中央动脉、睫状后动脉和视网膜中央静脉的收缩期峰值（PSV）和舒张末期（EDV）血流速度以及电阻率和搏动指数。结果：与健康对照者相比，DR患者眼动脉的年龄调整电阻率和搏动指数显着较高（p < 0.05）。患有 DR 的糖尿病患者的睫状后动脉 PSV 和 EDV 显着降低。进一步调整年龄、性别、HbA1c、空腹血糖、血压、BMI、胆固醇、HDL、LDL和甘油三酯后，与健康对照相比，DR患者仅眼动脉和视网膜中央静脉的电阻率指数仍然显着较高（Bonferroni调整后p < 0.005）。结论：眼动脉和视网膜中央静脉的电阻率指数改变在患者中可能普遍存在DR 的早期变化。
BACKGROUND: There have been conflicting results in relation to impaired ocular hemodynamics in the orbital vessels of patients with diabetic retinopathy (DR). Clarification of the early signs of retinopathy in diabetic patients is urgently needed.AIMS: We aimed to evaluate orbital blood flow velocities using Doppler and gray-scale sonography in patients with DR, and to compare the results with those of their non-diabetic and diabetic peers without retinopathy.METHODS: Orbital Doppler and gray-scale sonography were performed in 123 patients aged 29-77 who had been divided into 3 groups: non-diabetic controls (n = 25), diabetes and impaired glucose tolerance with minimal clinical retinopathy (n = 74), and diabetes with untreated non-proliferative retinopathy (n = 24). Retinopathy was diagnosed by an ophthalmologist on the basis of fundoscopic examination. The peak systolic (PSV) and end-diastolic (EDV) blood flow velocities, and the resistivity and pulsatile indices, of the ophthalmic artery, central retinal artery, posterior ciliary artery, and central retinal vein were measured.RESULTS: Compared with healthy controls, the age-adjusted resistivity and pulsatile indices of the ophthalmic artery were significantly higher in patients with DR (p < 0.05). PSV and EDV of the posterior ciliary arteries were significantly lower in diabetic patients with DR. After further adjustment for age, gender, HbA1c, fasting plasma glucose, blood pressure, BMI, cholesterol, HDL, LDL, and triglycerides, only the resistivity index of the ophthalmic artery and the central retinal vein remained significantly higher in patients with DR compared with healthy controls (p < 0.005 after Bonferroni adjustment).CONCLUSIONS: Resistivity index alteration of the ophthalmic artery and central retinal vein may be prevalent among patients with early changes in DR.