Doppler ocular ultrasound in patients with type 2 diabetes mellitus

Authors

DOI:

https://doi.org/10.31288/oftalmolzh202331723

Keywords:

type 2 diabetes mellitus, diabetic retinopathy, Doppler ultrasound, central retinal artery, ophthalmic artery, short posterior ciliary arteries

Abstract

Purpose: To determine ocular blood flow parameters by Doppler ultrasound scanning in type 2 diabetic patients with different stages of diabetic retinopathy.

Material and Methods: In this prospective study, forty-five patients (90 eyes) with type 2 diabetes mellitus were divided into three groups of 15 patients each: no diabetic retinopathy group (DR0), non-proliferative retinopathy (NPDR), and proliferative retinopathy (PDR) groups. Doppler indices such as systolic blood flow velocity (Vs), diastolic blood flow velocity (Vd), time-averaged maximum velocity (TAMXV), pulsatility index (PI) and resistivity index (RI) in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (SPCA) were determined. ANOVA was used for quantitative comparisons between the three groups.

Results: There was a significant (р < 0.05) decrease in (a) the Vs from 71.1 ± 20.6 cm/s in the DR0 group to 59.9 ± 16.7 cm/s in the  NPDR group and 47.4 ± 16.4 cm/s in the  PDR group, (b) Vd from 22.1 ± 6.9 cm/s to 17.0 ± 6.6 cm/s and 12.3 ± 5.9 cm/s, respectively; and (c) TAMXV from 37.2 ± 11.3 cm/s to 31.9 ± 9.1 cm/s and 25.3 ± 9.7 cm/s, respectively, and an increase in the RI from 0.69 ± 0.06 cm/s to 0.71 ± 0.09 cm/s and 0.75 ± 0.08 cm/s, respectively, in the OA. In addition, there was a significant decrease in the Vd from 9.9 ± 5.4 cm/s in the DR0 group to 8.1 ± 3.8 cm/s in the NPDR group and 5.5 ± 3.1 cm/s in the PDR group, and an increase in the PI from 1.34 ± 0.16 cm/s to 1.46 ± 0.28 cm/s and 1.54 ± 0.24 cm/s, respectively, and in the RI from 0.71 ± 0.06 cm/s to 0.75 ± 0.07 cm/s and 0.80 ± 0.05 cm/s, respectively, in the CRA. Moreover, there was a significant decrease in the Vd from 4.3 ± 1.6 cm/s in the DR0 group to 3.2 ± 2.0 cm/s in the NPDR group and 3.1 ± 2.2 cm/s in the PDR group, and an increase in the PI from 1.32 ± 0.21 cm/s to 1.37 ± 0.24 cm/s and 1.54 ± 0.26 cm/s, respectively, and in the RI from 0.76 ± 0.04 cm/s to 0.82 ± 0.06 cm/s and 0.82 ± 0.06 cm/s, respectively, in the SPCA.

Conclusion: We found that the arteries examined in patients with diabetic retinopathy tended to have decreased blood flow velocities and increased resistivity and pulsatility indices, with the greatest changes observed in patients with PDR. In addition, the difference in mean values of most Doppler indices between the PDR and NPDR groups was larger than that between the NPDR and DR0 groups.

References

World Health Organization et al. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus. - World health organization, 1999. WHO/NCD/NCS/99.2

Гогіна ІФ, Андріюк ЛВ, Огранович ОЄ. Діабетичні ангіо-, ретино-, невропатії: патогенез, клініка, лікування. Львів: Ліга Прес, 2000,168 с.

Жабоєдов ГД, Скрипнік РЛ, Сидорова МВ. Діабетична оптична нейропатія: основні аспекти патогенезу, клінічний перебіг та нові методи лікування. Офтальмол. журн. 2001; 1: 5-9.

Леус НФ. Метаболические механизмы развития и перспективы медикаментозного лечения диабетической ретинопатии. Офтальмол. журн. 2003; 5: 75-80.

Мальцев ЭВ, Родин СС, Черняева СН, Махмуд МР. Диабетическая ретинопатия: механизмы развития Офтальмол. журн. 2003; 2: 82-88.

Emerging Risk Factors Collaboration, Sarwar N, Gao P, Sechasai SR, Golin R, Kaptoge S et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010 Jun 26;375(9733): 2215-2222. https://doi.org/10.1016/S0140-6736(10)60484-9

Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol Rev. 2013. 93:137-88. https://doi.org/10.1152/physrev.00045.2011

Wei J, Tian J, Tang C, Fang X, Miao R, Wu H, et al. The influence of different types of diabetes on vascular complications. J Diabetes Res. 2022. 2022:3448618. https://doi.org/10.1155/2022/3448618

Cohen SR, Gardner TW. Diabetic retinopathy and diabetic macular edema. Dev Ophthalmol. 2016. 55:137-46. https://doi.org/10.1159/000438970

Kosiborod M, Gomes MB, Nicolucci A, Pocock S, Rathmann W, Shestakova MV, et al. Vascular complications in patients with type 2 diabetes: prevalence and associated factors in 38 countries (the discover study program). Cardiovasc Diabetol. (2018) 17:150. https://doi.org/10.1186/s12933-018-0787-8

Huang D, Refaat M, Mohammedi K, Jayyousi A, Al Suwaidi J, Abi Khalil C. Macrovascular complications in patients with diabetes and prediabetes. Biomed Res Int.2017:7839101. https://doi.org/10.1155/2017/7839101

Kawagishi T, Nishizawa Y, Emoto M, Konishi T. et al. Impaired Retinal Artery Blood Flow in IDDM Patients Before Clinical Manifestations of Diabetic Retinopathy. Diabetes Care. 1995; 18 (12): 1544-1549 https://doi.org/10.2337/diacare.18.12.1544

Erickson SJ, Hendrix LE, Massaro BM, Harris GJ, Lewandowski MF, Foley WD & Lawson TL: Colour Doppler flow imaging of the normal and abnormal orbit. Radiology. 1989. 173: 511-516. https://doi.org/10.1148/radiology.173.2.2678264

Aburn NS, Sergott RC. Orbital colour Doppler imaging. Eye., 1993. 7: 639-647. https://doi.org/10.1038/eye.1993.147

Lieb WE, Cohen SM, Merton DA, Shields JA, Mitchell DG & Goldberg BB: Colour Doppler imaging of the eye and orbit. Technique and normal vascular anatomy. Arch. Ophthalmol, 1991. 109: 527-532. https://doi.org/10.1001/archopht.1991.01080040095036

Baxter GM, Williamson TH. Colour Doppler imaging of the eye: normal ranges, reproducibility and observer variation. J Ultrasound Med. 1995. 14: 91-96. https://doi.org/10.7863/jum.1995.14.2.91

MacKinnon JR, McKillop G, O'Brien C, Swa K. Colour Doppler imaging of the ocular circulation in diabetic retinopathy. Acta Ophthalmol. Scand. 2000: 78: 386-389 https://doi.org/10.1034/j.1600-0420.2000.078004386.x

Stalmans I, Vandewalle E, Anderson DR, Costa VP et. al. Use of colour Doppler imaging in ocular blood flow research. Acta Ophthalmol (Copenh). 2011; 89:e609-e630. https://doi.org/10.1111/j.1755-3768.2011.02178.x

International Council of Ophthalmology. ICO Guidelines for Diabetic Eye Care (2017). Availble at: https://icoph.org/eye-care-delivery/diabetic-eye-care/

Mendivil A, Cuartero V, Mendivil MP. Ocular blood flow velocities in patients with proliferative diabetic retinopathy and healthy volunteers: a prospective study. Br J Ophthalmol. 1995; 79: 413-416. https://doi.org/10.1136/bjo.79.5.413

Goebel W, Lieb WE, Ho A, Sergott RC, Farhoumand R, Grehn F. Color Doppler Imaging: a new technique to assess orbital blood flow in patients with diabetic retinopathy. Invest Ophthalmol Vis Sci. 1995;36:864-870

Mendívil A. Ocular blood flow velocities in patients with proliferative diabetic retinopathy after panretinal photocoagulation. Surv Ophthalmol. 1997;42 (Suppl 1): 89-95. https://doi.org/10.1016/S0039-6257(97)80031-8

Dimitrova G, Kato S, Yamashita H, Tamaki Y, Nagahara M, Fukushima H, et al. Relation between retrobulbar circulation and progression of diabetic retinopathy. Br J Ophthalmol. 2003; 87: 622-625. https://doi.org/10.1136/bjo.87.5.622

Pemp B, Cherecheanu AP, Garhofer G, Schmetterer L. Calculation of central retinal artery diameters from non-invasive ocular haemodynamic measurements in type 1 diabetes patients. Acta Ophthalmol. 2013; 91: e348-e352. https://doi.org/10.1111/aos.12069

Published

2023-06-30

How to Cite

1.
Alifanov I. Doppler ocular ultrasound in patients with type 2 diabetes mellitus. J.ophthalmol. (Ukraine) [Internet]. 2023 Jun. 30 [cited 2024 May 15];(3):27-33. Available from: https://ua.ozhurnal.com/index.php/files/article/view/15

Issue

Section

Clinical Ophthalmology