Title : Colour doppler imaging of ocular circulation in diabetic patients with and without diabetic retinopathy
Abstract:
Diabetic Retinopathy (DR) is the most common microvascular complication in Diabetic patients and the leading global cause of vision loss in working middle-aged adults. Exposure to hyperglycaemia over an extended period and duration of diabetes are the most common risk factors that result in DR.
DR can be evaluated using various methods like Fundoscopy, Fundus photography, Fundus fluorescein angiography (FFA) and OCT to detect macular oedema. Fundoscopy detects anatomical changes in the blood vessels. It cannot assess the functional status or real time blood flow within these vessels which can be done by ocular doppler. Although FFA is the gold standard for DR, it cannot evaluate the retrobulbar ocular blood flow. Colour Doppler Imaging (CDI) is the most promising modality that produces conventional grey-scale ultrasound images along with details regarding the direc)on and velocity of blood flow. Colour doppler changes occur before definite anatomical changes. CDI is a safe, non-invasive and easily reproducible method for evaluating hemodynamic alterations in severe orbital and retinal vascular diseases.
The purpose of the study is to compare blood velocity and resistive index of retrobulbar vessels by Colour Doppler Imaging in diabetics with and without re)nopathy and also analysing the effect of various other systemic parameters like HbA1c, Hb, lipid profile on diabetic retinopathy using Colour Doppler Imaging. Method is by comparing the Peak Systolic Velocity(PSV) , End Diastolic Velocity (EDV) and Resistive Index (RI) of Ophthalmic Artery(OA) and Central Retinal Artery(CRA) in patients with and without Diabetic Retinopathy
Results show that the blood flow velocity is significantly reduced in patients with diabetic retinopathy when compared to those without retinopathy. The RI is found to be increased in patients with diabetic retinopathy as compared to patients without diabetic retinopathy and it is statistically highly significant when compared between
the two groups.
Even though further investigations are needed to assess orbital hemodynamics in diabetic retinopathy, based on our study the results suggest CDI has the ability to give the information on hemodynamic changes and can be used as a supportive modality for diagnosis of diabetic retinopathy in patients.
Audience Take Away Notes:
- Colour Doppler imaging as a supportive tool for diagnosis of diabetic retinopathy in patients
- Predicting the progression of diabetic retinopathy and proper lifestyle modifications and medications instituted early to prevent the manifestation of disabling retinopathy.
- How concurrent parameters like Hb, Hba1c, lipid profile affect the orbital blood flow in diabetic patients
