Hymodynamics In Cervical And Retrobulbar Vessels In Patients With Diabetic Retinopathy

Purpose: Diabetic retinopathy(DR) is an important cause of blindness in the world, its pathogenesis is very complex and the hemodynamic alterations in ocular circulation in patients with diabetes mellitus(DM) probably play an important role in the development of DR. This study was designed to investigate the relationship between hemodynamic changes in cervical and retrobulbar vessels in patients with DM and the development of DR, using color Doppler flow imaging(CDFI) technique, and to provide valuable theories for preventing and treating DR.Methods:1 Diabetic patients were divided into four different stages: no diabetic retinopathy(NDR), background diabetic retinopathy(BDR), pre-proliferative diabetic retinopathy(PPDR), and proliferative diabetic retinopathy(PDR), combining funduscopic examination and fundus fluorescein angiography(FFA).2 CDFI was used to quantitate diameter(D), peak systolic velocity(PSV), end diastolic velocity(EDV) andresistance index(RI) of the common carotid artery(CCA), the internal carotid artery(ICA), the ophthalmic artery(OA), the central retinal artery(CRA) in the control group and DM patients; to quantitate diameter(D), velocity(V) of central retinal vein(CRV); and to check carotid atherosclerosis .3 Four different stages DR were divided into separate study groups, hemodynamic parameters of each study group were compared to the control group's by the t-test respectively.4 The eyes were divided into two groups according as carotid atherosclerosis and non-carotid atherosclerosis ,hemodynamic parameters of the two groups were compared with each other by the t-test .5 The eyes with asymmetric diabetic retinopathy were divided into the severe eyes group and the better eyes group, and statistical comparison was performed by paired t-test.6 Correlation analysis was performed between age, blood pressure, intraocular pressure, duration of DM, free blood glucose and hemodynamic parameters of OA and CRA respectively.Results:1 CCA: No significant difference of hemodynamic parameters could be deduced between each study group and the control group(p>0.05).2 ICA: There was a significant decrease in both PSV(43.69±9.54cm/s) and EDV(16.91±2.56cm/s) in the PDR group compared to the control group(PSV: 53.36±9.96cm/s,EDV: 22.18±5.16cm/s)(p<0.05).3 The check-rate of carotid (including CCA and ICA) atherosclerosis: There was no significant difference in both the NDR group(16.7%,3/18) and the BDR group(20.7%,6/29) compared to the control group(10%,2/20)(p>0.05).The check-rate was significantly increased in both the PPDR group(54.2%,13/24) and the PDR group(66.7%,14/21) compared to the control group(p<0.01).4 OA: There was a significant decrease in both PSV(25.22±9.73cm/s) and EDV(5.93±3.36cm/s) in the PPDR group compared to the control group(PSV: 30.96±4.49cm/s,EDV: 9.58±1.80cm/s) and the BDR group (PSV:34.69±10.54cm/s,EDV:8.63±2.28cm/s)(p<0.05). There was a significant decrease in both PSV(23.79±7.58cm/s) and EDV(5.11±1.53cm/s) in the PDR group compared to the control group(p<0.01).RI was significantly increased in both the PPDR group(0.77±0.06) and the PDR group(0.78±0.06) compared to the control group(0.69±0.05)(p<0.01).5 CRA: There was a significant increase in both PSV(11.99±1.52cm/s) and EDV(4.38±0.64cm/s) in the NDR group compared to the controlgroup(PSV:10.08±1.73cm/s,EDV:3.93±0.51cm/s)(p<0.05). There was a significant decrease in both PSV and EDV in the BDR group(PSV:7.98±1.96cm/s,EDV:2.47±0.82cm/s),the PPDR group(PSV:7.60±2.31cm/s,EDV:2.53±0.85cm/s) and the PDR group(PSV:6.51±1.80cm/s,EDV:2.12±0.54cm/s) compared to the control group(p<0.01).RI was significantly increased in the BDR group(0.69±0.07),the PPDR group(0.66±0.05),the PDR group(0.68±0.05) compared to the control group(0.63±0.03)(p<0.05).6 CRV: V was significantly increased in the NDR group(5.36±0.78cm/s) compared to the control group(4.34±0.56cm/s)(p<0.01).There was a significant decrease in V in both the PPDR group(...