Güven D, Ozdemir H, Hasanreisoglu B
Department of Ophthalmology, Gazi University Faculty of Medicine, Ankara, Turkey.
Ophthalmology. 1996 Aug;103(8):1245-9. doi: 10.1016/s0161-6420(96)30514-9.
This study was designed to examine the characteristics of retrobulbar circulation and the role of glycemic control in patients with diabetes and varying stages of retinopathy.
Seventy-three eyes in 37 patients with diabetes were assigned to one of the following four study groups: nonproliferative diabetic retinopathy (non-PDR), proliferative diabetic retinopathy (PDR), post-panretinal photocoagulation (PRP), or preretinopathy (the control group). Color Doppler imaging was used to quantitate peak systolic blood flow velocities of the central retinal artery (CRA), the central retinal vein (CRV), the posterior ciliary artery (PCA) and the ophthalmic artery. Glycated hemoglobin (HbA1c) levels were used as an indicator of glycemic control.
The authors found that the CRA maximum blood flow velocity levels were significantly higher in the pre-retinopathy group (9.8 +/- 2.1 cm/second) than in the non-PDR group (8.1 +/- 2.2 cm/second). In addition, the CRV maximum blood flow velocity levels were significantly higher in the pre-retinopathy group (5.7 +/- 0.9 cm/second) than in both the PDR group (4.8 +/- 1.5 cm/second) and the PRP group (4.9 +/- 1.7 cm/second). No significant differences were seen in blood flow velocity levels of the ophthalmic artery and the PCA among the retinopathy groups. No correlation was found between HbA1c levels and the stage of retinopathy. The presence of systemic hypertension showed no significant effect on blood flow velocities in the various retinopathy groups.
This study demonstrates the presence of some circulatory changes in the CRA and the CRV in patients' eyes with diabetic retinopathy when compared with patients' eyes in the pre-retinopathy stage of the disease. These data support the contention that changes in retrobulbar circulation and microcirculation occur during the pathogenesis of diabetic retinopathy. The clinical significance of these findings needs to be determined.
本研究旨在探讨糖尿病患者不同视网膜病变阶段球后循环的特征以及血糖控制的作用。
37例糖尿病患者的73只眼被分为以下四个研究组之一：非增殖性糖尿病视网膜病变（非PDR）组、增殖性糖尿病视网膜病变（PDR）组、全视网膜光凝术后（PRP）组或视网膜病变前期（对照组）。采用彩色多普勒成像定量测量视网膜中央动脉（CRA）、视网膜中央静脉（CRV）、睫状后动脉（PCA）和眼动脉的收缩期峰值血流速度。糖化血红蛋白（HbA1c）水平用作血糖控制的指标。
作者发现，视网膜病变前期组的CRA最大血流速度水平（9.8±2.1厘米/秒）显著高于非PDR组（8.1±2.2厘米/秒）。此外，视网膜病变前期组的CRV最大血流速度水平（5.7±0.9厘米/秒）显著高于PDR组（4.8±1.5厘米/秒）和PRP组（4.9±1.7厘米/秒）。视网膜病变组之间眼动脉和PCA的血流速度水平无显著差异。未发现HbA1c水平与视网膜病变阶段之间存在相关性。全身性高血压的存在对各视网膜病变组的血流速度无显著影响。
本研究表明，与疾病视网膜病变前期的患者眼部相比，糖尿病视网膜病变患者眼部的CRA和CRV存在一些循环变化。这些数据支持了在糖尿病视网膜病变发病机制中球后循环和微循环发生变化的观点。这些发现的临床意义有待确定。
