Hemodynamic Correlation Study Of ICA,OA,CRA And PCA In Diabetic Retinopathy

PurposeDiabetes is a chronic metabolic disease that can cause damages to multiple organs throughout the body.It can cause a variety of complications in multiple organs.Diabetic patients are much affected by the occurrence and development of ocular complications,which includes damages of the retina,the macula,and the optic nerve.The impaired function of the retina is the main reason for decreased vision and even loss of vision in diabetic patients.In this study,color Doppler ultrasound has been used to observe the hemodynamic changes in the internal carotid artery(ICA),ophthalmic artery(OA),central retinal artery(CRA),and ciliary artery(PCA)in diabetic patients,and also the testing results of CDFI on ocular arterial blood flow parameters has been compared with those from fluorescein fundus angiography.According to these results,we studied the association of the changes(of OA,CRA,PCA and internal carotid hemodynamic parameters of the blood supply to the eye)with the development of DR in order to investigate the value of color Doppler in the preliminary diagnostic approach for DR.Materials and MethodsThe treatment group was tested with a Philislu Elite color Doppler ultrasound system and a Heidelberg Spectrali laser scanning confocal laser fundus scanning system.The treatment group consists of 156 eyes of 78 patients with diabetes mellitus and diabetic retina,which were further divided into three groups according to fundus angiography:43 eyes with Non-Diabetic Retinopathy(NDR),79 eyes with Non-Proliferative Diabetic Retinopathy(NPDR),and 34 eyes with Proliferative Diabetic Retinopathy(PDR).In the meanwhile,180 eyes of 90 healthy volunteers selected by our physical examination center were chosen as the normal standard group,which were divided into two groups according to age.The 62 eyes of people aged 25 to 45 were in the Normal Standard 1(NS1)group,and the 118 eyes of people aged 46 to 65 were in the Normal Standard 2(NS2)group,and the NS2 group was used as the control group.The patients in the NPDR group were treated with laser surgery.The blood flow parameters before surgery and the blood flow parameters after three months were compared.Statistical methodThe SPSS 16 statistical software was used to analyze the measured parameters.All measurements were expressed as average ? standard deviation(x ± s),and the difference was statistically significant at P<0.05.Results1.Compared with NS1 and NS2 in the normal group,systolic peak blood flow velocity PSV,end-diastolic blood flow velocity EDV and resistance index RI of OA,CRA and PCA did not change with age,and internal carotid artery ICA increased with age.The trend of PS V and EDV was decreasing,and the trend of resistance index was increasing.2.The changes of PSV,EDV and RI of ICA,OA,CRA and PCA in the treatment group and the control group were statistically different in each stage of retinopathy caused by hyperglycemia.In the PDR phase,the changes of PSV,EDV and RI in the ocular blood supply artery were the most obvious,and the resistance index was increasing in all stages of pathological changes of the retina caused by diabetes.However,ICA blood flow parameters only had significant statistical difference in the PDR phase.3.In the NPDR group,the PSV,EDV and RI of OA and CRA were statistically different before and 3 months after surgery.The PSV and EDV of OA and CRA decreased and RI increased.PSV,EDV and RI of PCA did not have significant difference.ConclusionApplying color Doppler to the blood supply arteries of the eye,the blood flow parameters of the large arteries ICA,small and medium arteries OA,CRA,PCA,we can find whether the ICA and the physiological anatomy of the eye have lesions or not.On the basis of this,we can monitor the blood flow parameters of ICA,OA,CRA and PCA,and observe the changes of hemodynamic parameters of ICA,OA,CRA and PCA to understand the perfusion of distal tiny blood vessels,so as to observe the progression of the pathological changes of the retina caused by diabetes clinically.In early ultrasound examination,the hemodynamic parameters of small arteries and infinitely small arteries are more sensitive than changes in blood flow parameters of the internal carotid artery.However,due to changes in the hyperglycemic environment of diabetes,the degree of intima-media thickness about the internal carotid artery may change in the early stage of diabetic disease,and may even cause carotid artery spasm,which may be related to the characteristics of the large and middle arteries.Although the internal carotid artery's hemodynamic changes cannot be used to detect the early retinopathy,its structural changes have certain relation with the disease,so in the color Doppler examination of DR,the check of the internal carotid artery is essential.