Abstract

HEMODYNAMICS OF ORBITAL VESSELS IN PATIENTS WITH AND WITHOUT DIABETIC RETINOPATHY USING COLOUR DOPPLER IMAGING

*Dr. Christina Samuel and Dr. Chris Joseph Chellaraj

Abstract

Background: Diabetic retinopathy is likely to pose a public health burden worldwide. As visual loss is being the end stage severe condition occurring in long standing cases, we look to provide a better modality to evaluate the progressive changes and help the patients with adequate anti-diabetic treatment to prevent further vascular damage and improve their quality of life with timely intervention. Purpose: To compare the hemodynamic changes of Orbital Artery (OA), Central Retinal Artery (CRA) and Short Posterior Ciliary Artery (SPCA) in Diabetic patients with and without Retinopathy and controls. To assess the monitoring potential of Colour Doppler Imaging (CDI) in the progression of Diabetes mellitus (DM)and Diabetic Retinopathy (DR)with the indices of Peak Systolic Volume (PSV), End Diastolic Volume (EDV) and Resistive Index (RI). Methods: 60 Patients were enrolled in this randomized and prospective study of age groups varying 50-80 years. With the help of dilated fundus with indirect Ophthalmoscopy they were categorized into 3 subgroups of 20 in each category with a total of 120 eyes. Group A as controls, Group B as Diabetes mellitus with no Retinopathy, Group C as Diabetic Retinopathy. Colour Doppler Imaging with GE VOLUSON S6 PRO ultrasound machine was used throughout the study with 7.5 MHz sector transducer probe for examining CRA, OA and SPCA in both eyes of the patient. Results: It is found that RI is increased in OA and CRA in Diabetic retinopathy (Group C) and CRA is more sensitive of all three vessels due to its peripheral vascular supply. PSV in OA is increased in Group C whereas it is reduced in CRA and SPCA. EDV is decreased in all three vessels in Diabetic retinopathy (Group C) as compared to controls and without Diabetic retinopathy. Conclusion: CDI can be used in evaluating the hemodynamic circulation in orbital vessels and is a useful modality to assess the progression of diabetic retinopathy when other techniques are inaccessible to these vessels. It gives reliable information on blood flow velocities at the sites of complex vasculature.

Keywords: Diabetic Retinopathy (DR), Colour Doppler Imaging (CDI), Ophthalmic Artery (OA), Central Retinal Artery (CRA) and Short Posterior Ciliary Artery (SPCA). Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV) and Resistive Index (RI).