彩色多普勒血流显像对低压性青光眼的血流动力学研究

目的观察低压性青光眼血流动力学变化。方法应用彩色多普勒检测１５例正常人和１９例低压性青光眼（ｌｏｗ－ｔｅｎｓｉｏｎｇｌａｕｃｏｍａ，ＬＴＧ）的眼动脉、睫状后短动脉及视网膜中央动脉的血流参数。测定收缩期血流峰值速度（ｐｅａｋｓｙｓｔｏｌｉｃｆｌｏｗｖｅｌｏｃｉｔｙ，Ｖｍａｘ）、舒张末期血流速度（ｅｎｄｄｉａｓｔｏｌｉｃｆｌｏｗｖｅｌｏｃｉｔｙ，Ｖｍｉｎ）、平均血流速度（ｍｅａｎｅｎｖｅｌｏｐｅｄｖｅｌｏｃｉｔｙ，Ｖｍｅａｎ）、搏动指数（ｐｕｌｓｅｉｎｄｅｘ，ＰＩ）、阻力指数（ｒｅｓｉｓｔａｎｃｅｉｎｄｅｘ，ＲＩ）及收缩期血流峰值速度和舒张末期血流速度比值（Ｖｍａｘ／Ｖｍｉｎ，Ｓ／Ｄ）。结果（１）ＬＴＧ组睫状后短动脉血流速度低于正常人组（两组双眼Ｖｍａｘ、Ｖｍｉｎ及右眼Ｖｍｅａｎ比较，Ｐ＜０．０５），左眼ＲＩ及Ｓ／Ｄ低于正常人组（Ｐ＜０．０５）；（２）ＬＴＧ组左眼视网膜中央动脉血流的Ｖｍａｘ及Ｖｍｅａｎ低于正常人组（Ｐ＜０．０１）；（３）ＬＴＧ组与正常人组眼动脉血流的Ｖｍａｘ等６项参数比较，差异无显著性（Ｐ＞０．０５）。结论ＬＴＧ组的睫状后短动脉血流速度低于正常人组，支持ＬＴＧ视乳头损害的血管学说。     

彩色多普勒成像技术检测视网膜静脉阻塞眼血流动力学的变化

目的探讨视网膜静脉阻塞（ｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＲＶＯ）患者视网膜中央动脉（ｃｅｎｔｒａｌｒｅｔｉ－ｎａｌａｒｔｅｒｙ，ＣＲＡ）和视网膜中央静脉（ｃｅｎｔｒａｌｒｅｔｉｎａｌｖｅｉｎ，ＣＲＶ）血流动力学特征及其意义。方法使用ＡＴＬ－ＨＤＩ３０００彩色多普勒诊断仪，检测ＲＶＯ患者患眼４８只、对侧临床健康眼３９只及正常对照眼４０只的ＣＲＡ收缩期峰值血流速度（ｐｅａｋｓｙｓｔｏｌｉｃｖｅｌｏｃｉｔｙ，ＰＳＶ）、舒张末期血流速度（ｅｎｄ－ｄｉａｓｔｏｌｉｃｖｅｌｏｃｉｔｙ，ＥＤＶ）和血管搏动指数（ｐｕｌｓａｔｉｌｉｔｙｉｎｄｅｘ，ＰＩ），ＣＲＶ最大血流速度（ｍａｘｉｍｕｎｖｅｌｏｃｉｔｙ，Ｖｍａｘ）。结果ＲＶＯ患眼、对侧临床健康眼ＣＲＡ的ＰＳＶ和ＥＤＶ均显著低于正常对照眼，ＲＶＯ患眼ＰＩ显著高于正常对照眼；ＲＶＯ患眼ＣＲＡ的ＰＳＶ显著低于ＲＶＯ对侧临床健康眼，ＲＶＯ患眼ＰＩ显著高于ＲＶＯ对侧临床健康眼；ＲＶＯ患眼、对侧临床健康眼ＣＲＶ的Ｖｍａｘ均显著低于正常对照眼。结论ＲＶＯ患眼和对侧临床健康眼血流动力学异常。彩色多普勒成像技术可作为其早期诊断的重要手段     

彩色多普靳血流显像对中晚期青光眼的眼血流动力学研究

目的：观察中晚期青光眼患者的眼血流动力学变化、了解血管因素在中晚期青光眼患者视功能损害机制中的作用。方法：应用彩色多普靳检测２０例（４０只眼）正常人和２１例（４２只眼）中晚期青光眼的眼动脉、睫状后短动脉及视网膜中央动脉的血流参数。测定收缩期峰值速度（Ｐｅａｋ Ｓｙｓｔｏｌｉｃ Ｖｅｌｏｃｉｔｙ，ＰＳＶ），舒张末期速度（Ｅｎｄ Ｄｉａｓｔｏｌｉｃ Ｖｅｌｏｃｉｔｙ，ＥＤＶ），计算其阻力指数（Ｒｅｓｉ     

颈内动脉血流动力学改变与前部缺血性视神经病变球后血流相关性研究

目的　通过彩色多普勒血流成像技术分别观察颈内动脉的血流动力学改变及前部缺血性视神经病变（ａｎｔｅｒｉｏｒｉｓｃｈｅ-ｍｉｃｏｐｔｉｃｎｅｕｒｏｐａｔｙ,ＡＩＯＮ）患者球后血流动力学改变,分析两者的相关性。方法　选取ＡＩＯＮ患者４２例,设为ＡＩＯＮ组,同时设立空白对照组４２例,分别检查两组人群的颈内动脉及球后主要血管睫状后短动脉的血流动力学指标,包括收缩期峰值血流速度（ｐｅａｋｓｙｓｔｏｌｉｃｖｅｌｏｃｉｔｙ,ＰＳＶ）、舒张末期血流速度（ｅｎｄｄｉａｓｔｏｌｉｃｖｅｌｏｃｉｔｙ,ＥＤＶ）、阻力指数（ｒｅｓｉｓｔａｎｃｅｉｎｄｅｘ,ＲＩ）,并对２组以上结果进行统计分析。结果　ＡＩＯＮ组与空白对照组球后主要血管睫状后短动脉的ＰＳＶ分别为（１０．２６±０．７３）ｃｍ?ｓ－１和（１１．６６±０.１９）ｃｍ?ｓ－１,差异有统计学意义（Ｐ＜０．０５）;ＥＤＶ分别为（３．６８±０．３８）ｃｍ?ｓ－１和（５．１２±０．５２）ｃｍ?ｓ－１,差异有统计学意义（Ｐ＜０．０５）;ＲＩ分别为０．７７±０．２７和０．６８±０．２２,差异有统计学意义（Ｐ＜０．０５）。颈内动脉血流动力学指标,ＡＩＯＮ组的ＰＳＶ为（９．１７±０．４２）ｃｍ?ｓ－１,明显低于空白对照组的（１０．６８±０．１８）ｃｍ?ｓ－１,差异有统计学意义（Ｐ＜０．０５）;ＡＩＯＮ组的ＥＤＶ为（２．１５±０．３１）ｃｍ?ｓ－１,明显低于空白对照组的（３．４７±０．５５）ｃｍ?ｓ－１,差异有统计学意义（Ｐ＜０．０５）;ＡＩＯＮ组的ＲＩ为０.６７±０.１２,明显高于空白对照组的０．５９±０．０７,差异有统计学意义（Ｐ＜０．０５）。ＡＩＯＮ组颈内动脉与球后主要血管睫状后短动脉的血流动力学指标高度相关,差异具有统计学意义（ｒ＝０．８２,Ｐ＝０．０００）。结论　ＡＩＯＮ患者的颈内动脉血流动力学已发生明显改变,并与球后血管睫状后短动脉的血流动力学改变高度相关,颈内动脉血流动力学改变可能是发生ＡＩＯＮ的因素之一。     

合并近视的原发性开角型青光眼眼血流动力学研究

目的：利用彩色多普勒血流显像研究合并近视的原发性开角型青光眼（Ｐｒｉｍａｒｙ Ｏｐｅｎａｎｇｌｅ Ｇｌａｕｃｏｍａｗｉｔｈ Ｍｙｏｐｉａ,ＭＰＯＡＧ）眼部血流动力学变化。方法：对３８ 例６３ 只合并近视（平均－６．９２ ±３ ．７９Ｄ）高眼压性（ 平均眼压３２ ．００±９．３６ｍｍＨｇ）ＰＯＡＧ、３２ 例５１ 只单纯原发性开角型青光眼（Ｓｉｍｐｌｅ Ｐｒｉｍａｒｙ Ｏｐｅｎａｎｇｌｅ Ｇｌａｕｃｏｍａ,ＳＰＯＡＧ） 、１５ 例３０ 只正常眼分别测量眼动脉、视网膜中央动脉、睫状后动脉的收缩期血流峰值速度（ＰＳＶ） 、舒张末期血流速度（ＥＤＶ） 、阻力指数（ＲＩ） 。结果：①与正常组比较：ＭＰＯＡＧ组及ＳＰＯＡＧ组视网膜中央动脉及睫状后动脉的ＲＩ升高（ Ｐ＜０．０５,Ｐ＜０ ．０１） ;ＭＰＯＡＧ 组眼动脉的ＥＤＶ值减低（Ｐ＜０．０５） 。②与ＳＰＯＡＧ 组比较：ＭＰＯＡＧ组眼动脉ＥＤＶ值明显减低（Ｐ＜ ０．０１）。结论：ＭＰＯＡＧ 患者眼部血流速度减低,血管阻力升高,有血流灌注不足的表现。提示眼压及血管因素在高眼压性ＭＰＯＡＧ 的视功能损害中均起着重要作用。     

经颅多普勒超声观察单侧重度颈内动脉狭窄时眼动脉血流改变

目的　通过经颅多普勒超声（ｔｒａｎｓｃｒａｎｉａｌＤｏｐｐｌｅｒ,ＴＣＤ）对单侧重度颈内动脉狭窄（ｉｎｔｅｒｎａｌｃａｒｏｔｉｄａｒｔｅｒｙｓｔｅｎｏｓｉｓ,ＩＣＡＳ）的患者进行眼动脉血流的检测,观察眼动脉血流与眼部缺血性疾病及颈内动脉狭窄程度的关系。方法　将经颈动脉彩色多普勒超声检查确诊为单侧重度ＩＣＡＳ的３１例及颈内动脉完全闭塞的１９例患者纳入研究。利用ＴＣＤ检查ＩＣＡＳ侧眼动脉血流方向、收缩期峰值血流速度（ｐｅａｋｓｙｓｔｏｌｉｃｖｅｌｏｃｉｔｙ,ＰＳＶ）及阻力指数（ｒｅｓｉｓｔａｎｃｅｉｎｄｅｘ,ＲＩ）,对比分析眼动脉逆向血流（ｒｅ-ｖｅｒｓｅｄｏｐｈｔｈａｌｍｉｃａｒｔｅｒｙｆｌｏｗ,ＲＯＡＦ）患眼及对侧眼眼动脉ＰＳＶ及ＲＩ值,同时对眼动脉血流方向与眼部缺血以及ＩＣＡＳ程度的关系进行分析。结果　经ＴＣＤ检查发现ＲＯＡＦ２４眼,其中单侧重度ＩＣＡＳ者９眼,颈内动脉完全闭塞者１５眼,ＲＯＡＦ在颈内动脉完全闭塞组更易出现,差异有统计学意义（χ２＝１１．７６,Ｐ＝０．００１）。２４例ＲＯＡＦ患者的阻塞侧ＰＳＶ值为（３８．６８±１１．５８）ｃｍ?ｓ－１,与健侧的（３３．５３±２．７４）ｃｍ?ｓ－１相比差异有统计学意义（ｔ＝２９．７３,Ｐ＝０．０００）;阻塞侧ＲＩ值为０．６０±０．１０,与健侧的０.７８±０.１０相比差异有统计学意义（ｔ＝－６．２０,Ｐ＝０．０００）。２４只ＲＯＡＦ眼中５８．３％有明确的眼部缺血体征,而２６只正流患侧眼中该比例为１５．４％,ＲＯＡＦ组患眼更容易出现眼部缺血体征（χ２＝９．９９,Ｐ＝０．００２）。利用Ｌｏｇｉｓｔｉｃ回归预测ＲＯＡＦ与眼部缺血的关系:回归系数为０．２１１（χ２＝１２．２６,Ｐ＝０．０００）,ＯＲ值为１．２３５。结论　当出现ＲＯＡＦ时,提示重度ＩＣＡＳ甚至完全闭塞;ＲＯＡＦ的流速越快,提示眼部出现缺血性病变的几率越大。     

青光眼血流动力学变化及其相关因素研究

用彩色多普勒血流成像（ｃｏｌｏｒｄｏｐｐｌｅｒｆｏｌｗｉｍａｇｉｎｇ,ＣＤＦＩ）技术研究青光眼病人眼血流动力学变化及检测指标的可靠性。方法：采用美国Ａｃｕｓｏｎ－１２８ＸＰ型彩多普勒超声仪测量发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎ－ａｎｇｌｅｇｌａｕｃｏｍａ,ＰＯＡＧ）２５例,原发性闭角型青光眼（ｐｒｉｍａｒｙａｎｇｌｅ－ｃｌｏｓｅｇｌａｕｃｏｍａ,ＰＡＣＧ）３０例和正常人３０例的眼动脉（ｏｐｈ     

全视野暗视敏感度对原发性开角型青光眼的早期诊断价值

为评价全视野暗视敏感度（ｗｈｏｌｅ－ｆｉｅｌｄｓｃｏｔｏｐｉｃｓｅｎｓｉｔｉｖｉｔｙ，ＷＳＳ）测定对原发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎ－ａｎｇｌｅｇｌａｕｃｏｍａ，ＰＯＡＧ）的早期诊断价值，经过３０分钟暗适应后，对１６例（１７只眼）早期ＰＯＡＧ，１２例（１４只眼）进展期ＰＯＡＧ，２５例（３２只眼）可疑ＰＯＡＧ及１５例（２０只眼）年龄匹配的正常人进行ＷＳＳ阈值测定。结果：这四组的平均ＷＳＳ阈值差异均具有显著性，分别为６．２４±２．４６ｄＢ，７．７９±２．１９ｄＢ，３．６３±２．４６ｄＢ，１．８５±１．６９ｄＢ。在可疑ＰＯＡＧ组中，随着危险因素的增加，ＷＳＳ阈值有上升趋势。ＷＳＳ阈值与ＰＯＡＧ患者的眼压最高水平值呈正相关（ｒ＝０．７６６，Ｐ＜０．００１）。结论：ＷＳＳ测定在青光眼的筛选中具有潜在性价值。     

原发性慢性闭角型青光眼黄斑区结构损害的定量研究及相关分析

目的　探讨慢性原发性闭角型青光眼（ｃｈｒｏｎｉｃｐｒｉｍａｒｙａｎｇｌｅ-ｃｌｏｓｕｒｅｇｌａｕｃｏｍａ,ＣＰＡＣＧ）患者黄斑区神经节细胞复合体（ｍａｃｕｌａｒｇａｎｇｌｉｏｎｃｅｌｌｃｏｍｐｌｅｘ,ｍＧＣＣ）厚度变化及与视网膜神经纤维层（ｒｅｔｉｎａｌｎｅｒｖｅｆｉｂｅｒｌａｙｅｒ,ＲＮＦＬ）厚度的相关性。方法　采用ＲＴＶｕｅ１００-２ＯＣＴ检测ＣＰＡＣＧ患者５５例（５５眼）早期、中期及晚期与正常人３０例（３０眼）平均、上方、下方ｍＧＣＣ厚度及平均、上方、下方ＲＮＦＬ厚度,比较组间各检测指标的差异,分析ｍＧＣＣ厚度与ＲＮＦＬ厚度的相关性。结果　早期ＣＰＡＣＧ组、中期ＣＰＡＣＧ组、晚期ＣＰＡＣＧ组平均、上方、下方ｍＧＣＣ厚度值分别为（９５．１５±８．２１）μｍ、（９６．１１±７．７７）μｍ、（９５．０５±９．９４）μｍ,（７６．０４±８．５８）μｍ、（８３．０４±８．７２）μｍ、（７４．１７±９．７１）μｍ,（６４．４０±１０．１３）μｍ、（６８．８３±１３．２６）μｍ、（６３．３４±１２．６１）μｍ。早期ＣＰＡＣＧ组、中期ＣＰＡＣＧ组、晚期ＣＰＡＣＧ组各ＲＮＦＬ及ｍＧＣＣ厚度值均较正常对照组降低,差异均有统计学意义（均为Ｐ＜０．０５）;随着青光眼病情的进展,ＲＮＦＬ厚度及ｍＧＣＣ厚度逐渐变薄,中期ＣＰＡＣＧ组各ＲＮＦＬ及ｍＧＣＣ厚度值均较早期ＣＰＡＣＧ组降低,差异均有统计学意义（均为Ｐ＜０．０５）,晚期ＣＰＡＣＧ组各ＲＮＦＬ及ｍＧＣＣ厚度值均较中期ＣＰＡＣＧ组降低,差异均有统计学意义（均为Ｐ＜０．０５）。ＣＰＡＣＧ患者平均ｍＧＣＣ厚度和平均ＲＮＦＬ厚度、上方ｍＧＣＣ厚度和上方ＲＮＦＬ厚度、下方ｍＧＣＣ厚度和下方ＲＮＦＬ厚度均呈高度正相关（ｒ＝０．９８７、０．９７６、０．９７１,均为Ｐ＝０．０００）。结论　频域ＯＣＴ检测的ＣＰＡＣＧ患者的ｍＧＣＣ厚度随青光眼病情的进展逐渐变薄,与ＲＮＦＬ厚度有良好的相关性。     

糖尿病患者的眼动脉和视网膜中央动脉血流动力学改变

目的 应用彩色多普勒显像（ｃｏｌｏｒ Ｄｏｐｐｌｏｒ ｆｌｏｗ ｉｍａｇｉｎｇ,ＣＤＦＩ）检测糖尿病患者,以探讨其血液动力学变化,提供有参考价值的数据。方法 应用ＣＤＦＩ检测了３０例糖尿病患者和５０例正常对照组的眼动脉（ｏｐｈ－ｔｈａｌｍｉｃ ａｒｔｅｒｙ,ＯＡ）、视网膜中央动脉（ｃｅｎｔｒａｌ ｒｅｔｉｎａｌ ａｒｔｅｒｙ,ＣＲＡ）的收缩期血流峰速（ｐｅａｋ ｓｙｓｔｏｌｉｃ ｖｅｌｏｃｉｔｙ,     

Ocular haemodynamics in pseudoexfoliative and primary open-angle glaucoma

OBJECTIVE: To compare the retrobulbar haemodynamic parameters in the ophthalmic artery (OA) and short posterior ciliary arteries (SPCA) in pseudoexfoliative and primary open-angle glaucoma patients. SUBJECTS AND METHODS: Fourty-three eyes from 43 patients with pseudoexfoliative glaucoma (PXE) and 31 eyes from 31 patients with primary open-angle glaucoma (POAG) who met the inclusion/exclusion criteria were included in this prospective cross-sectional study. Colour Doppler imaging measurements, peak systolic velocity (PSV), and end-diastolic velocity (EDV) were assessed in the OA and posterior ciliary arteries (PCA). Pourcelot resistivity indices (RI) were calculated. Visual function was assessed using the 24-2 Swedish Interactive Threshold Algorithm (SITA). The main outcomes of the study were PSV, EDV, and RI in the OA and SPCA. RESULTS: In POAG patients, PSV and EDV were significantly lower in the OA, P=0.003 and P<0.001 respectively, and in the PCA, P=0.003 and P<0.001 respectively, when compared with the PXE group. The RI was significantly higher, P<0.001, in both vessels, in the POAG group. CONCLUSION: The results of this study have found reduced PSV and EDV and increased RI in the retrobulbar vessels of POAG patients when compared with PXE patients.     

The association of ocular blood flow with haemorheological parameters in primary open‐angle and exfoliative glaucoma

Purpose: To evaluate the ocular blood flow velocities and haemorheological parameters in patients with primary open‐angle glaucoma (POAG), exfoliative glaucoma (XFG) and exfoliation syndrome (XFS) and to compare their results with those of healthy controls. Methods: Twenty‐five patients with POAG (group 1), 25 patients with XFG (group 2), 25 patients with XFS (group 3) and 25 healthy controls (group 4) were included in the study. Ocular blood flow velocities of ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (SPCAs) were measured using colour Doppler imaging (CDI). Haemorheological parameters (erythrocyte elongation and aggregation index, aggregation amplitude, aggregation half‐life, plasma viscosity, haematocrit) were measured in venous blood samples of all patients. Results: The peak systolic velocity (PSV) and end‐diastolic velocity (EDV) values were lower and resistive indices (RI) were higher for the OA, CRA and SPCA of glaucomatous (groups 1 and 2) patients compared with those of controls (group 4) (PSV: OA, 40.4 ± 11.3 versus 52.6 ± 12.8 cm/second, p < 0.001; CRA, 12.9 ± 2.9 versus 15.3 ± 4.2 cm/second, p = 0.02; SPCA, 21.7 ± 6.6 versus 26.6 ± 8.3 cm/second, p = 0.013) (EDV: OA, 10.3 ± 4.3 versus 14.2 ± 5.1 cm/second, p < 0.001; CRA, 3.7 ± 1.1 versus 4.5 ± 1.3 cm/second, p = 0.025; SPCA, 5.2 ± 1.8 versus 7.7 ± 3.2 cm/second, p = 0.001) (RI: OA, 0.75 ± 0.05 versus 0.66 ± 0.07, p < 0.001; CRA, 0.73 ± 0.08 versus 0.68 ± 0.10, p = 0.223; SPCA, 0.70 ± 0.10 versus 0.63 ± 0.11, p = 0.004). There were no statistically significant differences between the haemorheological parameters of glaucomatous and non‐glaucomatous patients. The reduction in ocular blood flow velocities in groups 1, 2 and 3 were not associated with changes in haemorheological parameters. Conclusion: Our results suggest that impairment of the retrobulbar blood flow in POAG and XFG is not associated with alterations in haemorheological parameters.     

Asymmetric visual field loss and retrobulbar haemodynamics in primary open-angle glaucoma

Purpose To investigate interocular differences in retrobulbar flow velocities in patients with asymmetric glaucomatous visual field loss.Methods Twenty-five patients with primary open-angle glaucoma (POAG) and asymmetric visual field loss were included in this study. Asymmetric visual field loss was defined as a difference of the global index mean deviation (MD) >6 dB between the two eyes. Flow velocities (peak systolic velocity PSV and end-diastolic velocity EDV) and resistive indices (RI) of the ophthalmic artery (OA), central retinal artery (CRA), and nasal and temporal posterior ciliary arteries were measured by means of colour Doppler imaging.Results MD of eyes with more severe glaucomatous visual field loss was −18.3±7.8 dB vs −6.8±5.5 dB (p<0.0001) in the less affected eyes. The PSV and the EDV of the CRA and the PSV of the OA were significantly decreased in eyes with more severe glaucomatous visual field loss (CRA PSV: 7.6±2.0 cm/s vs 8.3±1.7 cm/s, p=0.04; CRA EDV: 2.24±0.5 cm/s vs 2.55±0.6 cm/s, p<0.007; OA PSV: 29.7±9.9 cm/s vs 32.7±11.5 cm/s, p<0.02). None of the other differences in velocity or resistive index were significant.Conclusions Patients with asymmetric glaucomatous visual field loss exhibit asymmetric flow velocities of the CRA and OA. Patients with more severe damage display reduced flow velocities in retrobulbar vessels in POAG.     

Ocular blood flow velocity determined by color Doppler imaging in diabetic retinopathy

PURPOSE: To measure and investigate changes of blood flow velocity by color Doppler imaging in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (PCA) in diabetic retinopathy (DR) and to compare the results with those in healthy control subjects. METHODS: In this investigation we included 44 eyes of 44 diabetic patients with different stages of DR forming group NPDR (11 eyes with mild and 11 eyes with moderate nonproliferative DR) and group SNPDR/PDR (19 eyes with severe nonproliferative and 3 eyes with proliferative DR) and 22 eyes of 22 healthy age- and sex-matched subjects forming control group HC. With color Doppler imaging we measured the peak systolic velocity (PSV, cm/s) and end-diastolic velocity (EDV, cm/s) of blood flow in the OA, CRA and PCA. The resistance index of each vessel was then calculated. Statistical analysis comparing the results of groups NPDR, SNPDR/PDR and HC was carried out. Statistical significance was set at p < 0.05. RESULTS: There was a statistically significant increase in PSV in the OA in group SNPDR/PDR compared with group HC (35.71 +/- 6.90 vs. 31.45 +/- 4.32 cm/s; mean +/- SD). There was a statistically significant decrease in PSV in the CRA in group NPDR compared with group HC (8.50 +/- 1.62 vs. 10.61 +/- 1.75 cm/s; mean +/- SD) and in group SNPDR/PDR compared with group HC (7.34 +/- 1.78 vs. 10.61 +/- 1.75 cm/s; mean +/- SD), also there was a statistically significant decrease in EDV in group SNPDR/PDR compared with group HC (2.05 +/- 0.53 vs. 3.00 +/- 0.81 cm/s; mean +/- SD). A statistically significant decrease in EDV in the PCA in group SNPDR/PDR compared with group HC (2.95 +/- 1.04 vs. 3.95 +/- 0.98 cm/s; mean +/- SD) was found, also there was a statistically significant increase in the resistance index in group SNPDR/PDR compared with group NPDR (0.72 +/- 0.05 vs. 0.67 +/- 0.07; mean +/- SD) and in group SNPDR/PDR compared with group HC (0.72 +/- 0.05 vs. 0.67 +/- 0.05; mean +/- SD). CONCLUSIONS: In this investigation, color Doppler imaging was used to determine significant changes of blood flow velocity in the OA, CRA and PCA in DR compared with healthy control subjects and the changes of blood flow velocity become further significant considering the progression of DR. This points to the presence of circulatory changes in the OA, CRA and PCA in diabetic patients with DR.     

Hemodynamic evaluation of the posterior ciliary circulation in exfoliation syndrome and exfoliation glaucoma

BACKGROUND: Previous studies have reported impaired blood flow in the ophthalmic artery (OA) and central retinal artery (CRA) in exfoliation syndrome and exfoliation glaucoma. This study evaluates blood flow at the long and short posterior ciliary arteries (LPCA and SPCA, respectively) in these conditions. METHODS: Consecutively examined candidates for cataract surgery were included. Only one eye (OD) was included in the analyses for consistency. Patients were classified into non-glaucoma and non-exfoliation (controls), primary open angle glaucoma (POAG), exfoliation syndrome and exfoliation glaucoma groups, based on the findings of the OD. Sixty-eight patients (41 males, 60.3%) were included. Color Doppler imaging (CDI) of the nasal and temporal branches of LPCA and SPCA was performed using a 7.5 Mhz probe. The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistivity index (RI) were recorded for the examined vessels. RESULTS: EDV at the LPCA was significantly lower in exfoliation syndrome and glaucoma, compared with controls and POAG respectively. EDV was significantly lower and RI was significantly higher at the SPCA in exfoliation glaucoma, compared with exfoliation, whereas respective differences were statistically not significant between controls and POAG. CONCLUSIONS: The hemodynamic impairment at the LPCA in exfoliation syndrome and glaucoma supports an association between exfoliation and ischemic stress at the anterior ocular segment.     

青光眼小梁切除术前后眼部血流动力学变化的研究

目的:比较青光眼32眼小梁切除术前后的血流动力学变化。方法:利用彩色多普勒成像技术(CDI)分别检测正常对照组与青光眼组术前、术后2,12wk的眼部血流情况,包括眼动脉(OA)、睫状后短动脉(SPCA)和视网膜中央动脉(CRA)的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)和阻力指数(RI)。结果:(1)青光眼组手术前后比较:青光眼组在小梁切除术后血流灌注明显好转,表现为PSV,EDV增高,RI下降;(2)青光眼术后组之间比较:PSV,EDV,RI有改变,但差异无统计学意义;(3)青光眼组术后与正常对照组比较:青光眼组在小梁切除术后眼压降至正常范围时OA,SPCA,CRA的PSV,EDV和RI仍不及正常人(P<0.05);(4)青光眼组术前与正常对照组比较:OA,SPCA,CRA均表现为PSV,EDV下降,RI增高(P<0.01)。结论:(1)青光眼患者与正常人相比较存在明显的血流灌注不足,小梁切除术可以有效的改善眼部血流灌注情况;(2)CDI可长期用于监测和评价青光眼小梁切除术的治疗效果。     

Variations in ocular hemodynamics in patients with early and late glaucoma

PURPOSE: To determine the retrobulbar hemodynamics in glaucoma patients with different degrees of optic nerve damage. METHODS: Color Doppler imaging was performed in 52 patients with controlled primary open angle glaucoma (POAG) and in 25 control subjects. Glaucomatous eyes were divided into early and late groups based on the perimetry findings. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index of the central retinal artery (CRA) and posterior ciliary arteries (PCA) were evaluated. RESULTS: Early glaucoma showed significantly decreased PSV in nasal PCA when compared with the normal. Late glaucoma showed significantly decreased PSV and EDV in the CRA and nasal PCA, and significantly decreased PSV in temporal PCA as compared with the control and early glaucoma. The resistive index of the CRA also increased significantly in late glaucoma. CONCLUSION: Eyes with advanced glaucomatous optic neuropathy were associated with more marked alterations in retrobulbar circulation than eyes with less nerve damage.     

双眼非对称性原发性开角型青光眼的眼部血流动力学研究

目的 探讨眼球后血管血流速度降低及阻力指数升高与原发性开角型青光眼的关系。方法 应用彩色多普勒成像技术对33例双眼非对称性青光眼患者正常对照组26例进行检测，测量眼动脉，视网膜中央动脉及睫状后短动脉的收缩期峰值流速（PSV）及舒张末期流速（EDV）并计算其阻力指数（RI）。结果 在青光眼患者中，无论是视野及视神经损害较重眼还是视野及视神经均正常的对侧眼，其视网膜中央动脉及睫状后短动脉的PSV和EDV均明显高于正常对照组，而ＲＩ低于正常对照组；双眼进行比较发现较重侧眼的视网膜中央动脉的ＰＳＶ和ＥＤＶ均低于对侧眼，结论　眼球后血管的血流速度下降存在于青光眼视神经损害之前，与青光眼的发生可能有一定的关系；在双眼非对称性青光眼中，视网膜中央动脉的血流速度降低和高眼压可能是导致青光眼性视神经损害的原因。     

The effects of cyclopentolate on intraocular pressure and retrobulbar hemodynamics in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma

PURPOSE: To evaluate the changes of intraocular pressure (IOP) and retrobulbar hemodynamics after cyclopentolate administration in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma. METHODS: Eighteen patients with pseudoexfoliation syndrome and 18 patients with pseudoexfoliation glaucoma were enrolled in the study. After baseline measurements of IOP, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were investigated by color Doppler imaging. Then, 1% cyclopentolate was instilled in one eye of each subject. After 45 minutes of instillation of the cyclopentolate, the measurements of IOP and retrobulbar blood flow velocities were repeated. The results were compared with those of 20 age-matched normal subjects. RESULTS: Neither IOP nor retrobulbar blood flow velocities changed significantly in control subjects after cyclopentolate administration. IOP increased significantly after cyclopentolate instillation in pseudoexfoliation syndrome (p = 0.004). Retrobulbar blood velocities did not change significantly after the cyclopentolate in this group. In pseudoexfoliation glaucoma group, it was observed that basal mean IOP showed a statistically significant increase after cyclopentolate drop (p = 0.002). Although blood flow velocities of ophthalmic artery did not change significantly, PSV and EDV of the central retinal and posterior ciliary arteries decreased significantly (p < 0.05) and RI of the posterior ciliary artery increased significantly (p = 0.01) after cyclopentolate instillation. CONCLUSIONS: On the basis of our findings, pseudoexfoliation appears to be a predictive factor for an IOP rise after cyclopentolate. In pseudoexfoliation glaucoma patients, an increase of IOP after cyclopentolate could lead to a decreased retrobulbar blood flow. IOP must be rechecked after cyclopentolate administration in these patients to avoid further damage to the ganglion cells.     

颅内段颈内动脉狭窄与眼部动脉血流状态及视网膜血管形态的相关性

目的：探讨颅内段颈内动脉狭窄与眼部动脉血流状态及视网膜血管形态的相关性。

方法：选取2017-01/2018-06因疑似脑缺血来我院就诊的患者251例,根据颈内动脉狭窄程度分为无狭窄组(39例)、轻度狭窄组(80例)、中度狭窄组(83例)、重度狭窄组(49例)。比较四组患者眼部动脉血流动力学指标及视网膜血管管径,分析眼部血流参数与颅内段重度颈内动脉狭窄的相关性及诊断价值。

结果：重度狭窄组患者眼动脉(OA)、视网膜中央动脉(CRA)、睫状后动脉(PCA)的血管血流参数收缩峰流速(PSV)和舒张峰流速(EDV)均低于其他三组,且PSV、EDV与重度狭窄组患者颈内动脉狭窄率呈显著负相关,其中PCA PSV、PCA EDV对颅内段重度颈内动脉狭窄诊断最佳临界值分别为11.26、5.21cm/s。

结论：颅内段颈内动脉狭窄与眼部动脉PSV、EDV呈显著负相关,其中PCA PSV、PCA EDV对于颅内段颈内动脉狭窄最敏感。