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基于多普勒超声对无视网膜病变及轻度非增殖性视网膜病变的1型糖尿病患者眼动脉和视网膜中央动脉血流动力学变化的评估。

Doppler ultrasound-based evaluation of hemodynamic changes in the ophthalmic artery and central retinal artery in patients with type 1 diabetes mellitus without retinopathy and with mild non-proliferative retinopathy.

作者信息

Pauk-Domańska Magdalena, Wilczewska Agnieszka, Jaguś Dominika, Kaczyński Bartosz, Jakubowski Wiesław

机构信息

Ophthalmology Department, Laser Clinic, Mazovian Brodnowski Hospital, Warsaw, Poland.

Diabetology Department, Diabetic Clinic, Mazovian Brodnowski Hospital, Warsaw, Poland.

出版信息

J Ultrason. 2024 Mar 14;24(96):20240009. doi: 10.15557/jou.2024.0009. eCollection 2024 Feb.

Abstract

AIM

Determination of blood flow parameters in the ophthalmic artery and central retinal artery using Doppler ultrasound in patients with type 1 diabetes mellitus without fundus signs of diabetic retinopathy and with mild non-proliferative retinopathy.

MATERIAL AND METHODS

To eliminate the impact of other systemic factors on vascular flow, the study enrolled a total of 80 patients with type 1 diabetes mellitus, aged between 18 and 45 years. The study participants did not have any diabetic complications or other systemic or ocular comorbidities. The control group comprised 81 healthy individuals within a similar age range. Color Doppler ultrasound examinations of the ophthalmic artery and central retinal artery were performed to evaluate selected blood flow parameters including peak systolic velocity, end-diastolic velocity, and resistance index.

RESULTS

Patients with type 1 diabetes mellitus exhibited statistically significant decrease in both systolic and end-diastolic velocities in the central retinal artery, accompanied by an elevation in resistance index, compared to the control group. The study revealed differences in blood flow parameters between the patients without fundus changes and those exhibiting mild non-proliferative retinopathy. Specifically, patients with retinopathy showed a significant decrease in both systolic velocity and end-diastolic velocity in the central retinal artery. No differences were observed for the same parameters in the ophthalmic artery. When analyzing the patients' blood flow parameters in relation to the degree of diabetes control, as determined by glycated hemoglobin levels, a statistically significant reduction in systolic velocity was identified in both the ophthalmic and central retinal arteries in the group with poorly controlled diabetes.

CONCLUSIONS

Examination of the orbital vessels using Doppler ultrasound in patients with type 1 diabetes mellitus holds promise as an effective method for early detection of vascular abnormalities.

摘要

目的

使用多普勒超声测定1型糖尿病且无糖尿病视网膜病变眼底体征及轻度非增殖性视网膜病变患者的眼动脉和视网膜中央动脉血流参数。

材料与方法

为消除其他全身因素对血管血流的影响,本研究共纳入80例年龄在18至45岁之间的1型糖尿病患者。研究参与者无任何糖尿病并发症或其他全身或眼部合并症。对照组由81名年龄范围相似的健康个体组成。对眼动脉和视网膜中央动脉进行彩色多普勒超声检查,以评估选定的血流参数,包括收缩期峰值流速、舒张末期流速和阻力指数。

结果

与对照组相比,1型糖尿病患者视网膜中央动脉的收缩期和舒张末期流速均有统计学意义的降低,同时阻力指数升高。研究揭示了无眼底改变的患者与表现为轻度非增殖性视网膜病变的患者之间血流参数的差异。具体而言,患有视网膜病变的患者视网膜中央动脉的收缩期流速和舒张末期流速均显著降低。眼动脉的相同参数未观察到差异。当根据糖化血红蛋白水平分析患者的血流参数与糖尿病控制程度的关系时,发现糖尿病控制不佳组的眼动脉和视网膜中央动脉的收缩期流速均有统计学意义的降低。

结论

对1型糖尿病患者使用多普勒超声检查眼眶血管有望成为早期发现血管异常的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ef/10940271/b1fa2b97dada/j_jou.2024.0009_fig_001.jpg

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