糖尿病眼的微循环血液动力学研究

目的研究糖尿病眼的微循环血液动力学变化.方法应用彩色多普勒对糖尿病的124只眼和正常对照组100只眼的视网膜中央动脉(CRA)的收缩期流速(PSV)、舒张期流速(EDV)、搏动指数(PI)、阻力指数(RI)进行对比分析.结果糖尿病组视网膜中央动脉PSV、EDV低于正常组(P＜0 01),PI、RI两组无明显差异.结论糖尿病眼的微循环血液动力学改变主要是PSV、EDV降低,这对判断糖尿病视网膜病变及视网膜的功能,有一定临床价值.     

眼外伤的眼底血流动力学研究

目的研究眼外伤的眼底血流动力学变化。方法应用彩色多普勒显像检测６２只正常眼和 ９２只眼外伤患者的视网膜中央动脉（ＣＲＡ）、睫状后短动脉（ＳＰＣＡ）的血流参数,测定收缩期流速（ＰＳＶ）、舒张期流速（ＥＤＶ）、搏动指数（ＰＩ）、阻力指数（ＲＩ）。结果眼外伤组的 ＣＲＡ的 ＰＳＶ、ＲＩ均低于正常组（Ｐ＜０．０１）、ＣＲＡ的 ＥＤＶ、ＰＩ及 ＳＰＣＡ的 ＰＳＶ、ＥＤＶ、ＰＩ、ＲＩ两组比较均未见明显差异。结论眼外伤组ＣＲＡ血供降低是引起视功能障碍的重要原因之一,给临床对眼外伤的诊治和预后提供重要的依据。     

老年大鼠模型视网膜血管改变及视网膜中央动脉血流变化的高分辨率超声图像检测

背景：视网膜对缺血非常敏感,所以眼部血流动力学的改变可直接影响眼的功能,目前评估眼部血液循环可借助多种仪器设备。 目的：应用高分辨率小动物超声影像系统检测视网膜中央动脉的血流动力学变化,结合视网膜血管消化铺片技术检测视网膜血管结构变化,以明确老年大鼠视网膜中央动脉血流动力学的变化规律。 方法：使用高分辨率小动物超声影像系统测量老年大鼠和青年大鼠及视网膜中央动脉的血流参数,包括收缩期峰值血流速度、舒张末期血流速度,计算搏动指数、阻力指数和收缩期舒张期血流速度比值。同时使用视网膜血管消化铺片技术检测视网膜血管形态学改变。 结果与结论：与青年大鼠组相比,老年组大鼠视网膜血管内皮细胞增生,排列紊乱,管径增粗,血管壁不光滑;视网膜中央动脉血流速度、舒张末期血流速度均降低(P < 0.01),计算搏动指数、阻力指数及收缩期峰值与舒张末期血流速度比值则升高(P < 0.01)。说明使用高分辨率小动物超声影像系统检测视网膜中央动脉收缩期和舒张期峰值速度及阻力指数能较敏感地反映血管的老化过程。     

彩色双功能多普勒超声评价睾丸的血流特点及其意义

目的:应用高频率二维及彩色多普勒超声,探讨正常成人睾丸及其血流的彩色多普勒超声特点.方法:经阴囊超声检测120例正常成年男性的睾丸及其血流的彩色多普勒频谱,测睾丸动脉(TA)、包膜动脉(CA,即睾丸动脉主支)、睾丸内动脉(ITA,包括向心动脉和中央动脉)的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、时间平均峰值血流速度(TAMX)、阻力指数(RI)和搏动指数(PI);分别计算左右侧睾丸大小和血流参数的均值,并作t检验进行分析.结果:120例正常成人左、右侧睾丸大小及其血管的PSV、EDV、TAMX、RI和PI测值无显著性差异.CA和ITA多普勒频谱波型变化较小,为低阻力型血流频谱;TA的波型变化较大,RI、PI值变异较大.结论:高频率彩色双功能多普勒超声敏感性高,可准确检测睾丸的形态结构及其血管的血流动力学参数,且左、右侧睾丸测值差异无显著意义(P>0.05).     

彩色多普勒评价音乐胎教对胎儿血流动力学影响的探讨

目的用彩色多普勒超声评估音乐胎教前后对胎儿血流动力学的影响,为推广普及音乐胎教提供科学依据.方法对60例孕龄24-42周健康孕妇采用Acuson128×P/10型电脑仪,彩色多普勒血流显像分别显示音乐胎教前后胎儿脐动脉、大脑中动脉及升主动脉血流,分别测量其脐动脉,大脑中动脉搏动指数(PI),阻力指数(RI),收缩期流速/舒张期流速(S/D)比值以及升主动脉血流速度、心输出量及心率.结果音乐胎教后,胎儿主动脉血流速度增加,心输出量增加,胎儿心率无明显变化.胎儿脐动脉、大脑中动脉PI、RI、S/D均下降.结论音乐胎教能增加心输出量,改善脐-胎盘及大脑血液供应.彩色多普勒血流显像技术探测音乐胎教前后胎儿血流动力学改变,具有实用性、无创性、重复性好等优点.     

头皮血肿新生儿大脑中动脉血流动力学的超声影像学分析

目的探讨新生儿头皮血肿对大脑中动脉血流动力学的影响。方法采用飞利浦公司的Philips iU22彩超仪测量55例头皮血肿新生儿及30例正常新生儿大脑中动脉的收缩期峰值流速、舒张末期血流速度及阻力指数,比较两组间各参数;分析头皮血肿侧大脑中动脉阻力指数与头皮血肿深度的相关关系。结果头皮血肿新生儿大脑中动脉收缩期峰值流速降低,舒张末期流速降低,阻力指数升高,与正常儿童组比较,有统计学差异（P〈0.05）;头皮血肿侧大脑中动脉的阻力指数与头皮血肿厚度呈正相关关系（r=0.4,P=0.042）。结论头皮血肿新生儿大脑中动脉血流动力学发生显著改变,预示同时存在其它并发症的可能。     

视网膜中央动脉对视神经血供关系的研究

采用碳素墨水动脉灌注和苯浸渍透明研究了３０例视网膜中央动脉的起点，经过和分支分布情况。视网膜中央动脉可发自眼动脉，亦可与内侧睫状后短动脉或与外侧睫状后短动脉共干发自眼动脉。按视网膜中央动脉的经过可分为眶内段、鞘内段和神经内段。观察了各段的分支及其与其它动脉分支之间的吻合情况。讨论了视网膜中央动脉对视神经血供关系的生理意义，为眼科临床提供了形态学基础。     

子痫前期孕妇肾动脉血流参数变化的彩超论断价值

目的探讨彩色多普勒血流显像检测子痫前期孕妇肾动脉血流参数变化的意义。方法本研究随机选取100例正常妊娠妇女为对照组,选取经临床确诊的116例子痫前期患者为研究对象,按病情分为轻度子痫前期60例,重度子痫前期56例。应用彩色多普勒超声检测各组孕妇肾门处肾动脉主干及肾叶间动脉（IRA）收缩期峰值流速（Vs）、舒张末期最低流速（Vd）、上升加速度（AC）、阻力指数（RI）。结果与对照组及轻度子痫前期组比较,重度子痫前期组肾门处及肾内叶间动脉血流参数Vs、RI、AC均明显升高（P〈0．01）,Vd明显下降（P〈0．05）,差异均有统计学意义;而轻度子痫前期组与对照组比较,其肾门处及肾内叶间动脉各项血流参数均无统计学差异（P〉0．05）。结论随着病情严重程度的增加,重度子痫前期患者肾门处及肾内叶间动脉收缩期流速明显升高,阻力增大,而舒张期流速明显减低,彩色多普勒超声无创、可重复性好,能较准确检测子痫前期患者肾动脉血流动力学变化,有较好的临床应用价值。     

视网膜中央动脉和睫状后动脉的应用解剖

目的：为视神经鞘减压术和视神经周围区手术提供视网膜中央动脉和睫状后动脉的解剖学资料。方法：采用显微解剖学技术对60例成人视网膜中央动脉和睫状后动脉进行观察。结果：（1）视网膜中央动脉多发自眼动脉角（21．7％）,内侧睫状后动脉（20．0％）,眼动脉第一段（19．3）。（2）视网膜中央动脉发起后在视神经下方弯曲前行,其起始部在眶内视神经后1／3段与眼外直肌之间者占85．0％。（3）入鞘点在视神经的正下方者68．3％,内下方者占21．7％,外下方者占10．0％。结论：视网膜中央动脉及睫状后动脉的起点、走行变化较大,视神经鞘减压术和视神经周围区手术时应保护好这些动脉,以免引起视神经等结构缺血。     

颜面部美容注射引发眼部并发症解剖分析

目的分析颜面部美容注射后引发视网膜中央动脉阻塞或眼动脉阻塞的颜面部血管吻合解剖学特点。方法回顾性分析2010年6月至2015年6月3例因额面部美容后出现视力急剧下降,经眼底检查、荧光素视网膜血管造影检查确诊为视网膜中央动脉阻塞的患者,分析注射部位血管分布及眶周血管吻合特点。结果 3例患眼均无光感并伴有眼痛或(及)眼球转动痛,视网膜血管造影均表现为完全性中央动脉阻塞;面部美容注射压在开始注射2 s后就大大超过眼动脉收缩压(P0.05);鼻背动脉与内眦动脉多有吻合,内眦动脉常与后睫状长动脉的鼻侧分支吻合。填充物进入上述血管后可经吻合动脉分支进入眼动脉,使得填充物阻塞与眼动脉、视网膜中央动脉、睫状后短动脉及其分支内。结论颜面部美容注射时,注射物可能会进入眶周围动脉,逆行流入眼动脉,造成眼动脉阻塞,或经眼动脉流入视网膜中央动脉、睫状动脉,从而造成严重的眼部并发症。     

Features of the cerebral and ocular blood flow in patients with different clinical course of myopia

A total of 3 groups of patients aged 16-32 years: 1st-30 patients (60 eyes)--with a stationary myopia of 6.5 to 9.0 D and normal intraocular pressure (IOP); 2nd-23 patients (46 eyes)--with a high degree of progressive myopia and glaucoma with normalized intraocular pressure during instillation azopta included 2 subgroups: subgroup A--14 patients (28 eyes) - with ischemic variant of glaucoma; subgroup B--9 patients (18 eyes)--with dyscirculatory variant of glaucoma; 3rd group (control)--10 somatically healthy individuals of similar age. Results of color Doppler mapping of the main arteries of the brain and the eyeball revealed features: the predominance of the ability of middle cerebral arteries to vasoconstriction combined with reduced blood flow in central retinal artery and short posterior ciliary arteries and cause ischemica variant of glaucoma, slowing blood flow in the vertebrobasilar basin combined with a reduction of venous outflow of the of the eyeball and is accompanied by the development of glaucoma in dyscirculatory variant in patients with myopia of high degree.     

Early impact of hormone replacement therapy on vascular hemodynamics detected via ocular colour Doppler analysis

Objective: To determine the effects of hormone replacement therapy (HRT) on ocular blood flow.

Study design: In a prospective controlled study, 40 healthy women who presented to the menopause clinic between December 2000 and December 2001 were randomly assigned into the study. The HRT-receiving group was administered estradiol 17-valerate 2 mg the first 11 days, and estradiol 17-valerate 2 mg plus ciproterone acetate 1 mg the next 10 days of the monthly cycle for 6 months. The control group did not receive any HRT for 6 months. The ocular colour Doppler analysis were performed at baseline and after 3 and 6 months. The ocular Doppler analysis was performed in the first half of the cycle in the HRT-receiving group.

Results: Central retinal artery and ophthalmic artery basal Doppler index (peak systolic velocity, end-diastolic velocity, resistive index and pulsatility index) values of the two groups at the beginning of the study did not show any statistically significant difference. Both the right and the left central retinal artery pulsatility index (PI) values of the study group, who received HRT at the end of the third and sixth months, showed a statistically significant decline (paired-samples test, P < 0.05), while the decrease in the resistive indexes was not significant.

Conclusion: These results suggest that 6 months of combined hormone replacement therapy with estradiol 17-valerate 2 mg plus ciproterone acetate 1 mg improves ocular vascular Doppler indices which may be a reflection of cerebral vascular status.     

Central retinal artery originating from the temporal short posterior ciliary artery associated with intraorbital external-to-internal carotid arterial anastomoses

Although variations in the peripapillary division pattern of the central retinal artery (CRA) are common, variations in the origin of this artery are seldom reported in the literature. Herein, the authors report a variant of the CRA that originated from the temporal short posterior ciliary artery. Two intraorbital anastomoses were also noted between the internal and external carotid arterial systems: one through the lacrimal artery–middle meningeal artery to the ophthalmic artery and the other through supraorbital artery–recurrent meningeal artery to the ophthalmic artery. A brief review of CRA variations and potential clinical significances of the observed variant are discussed.     

Blood flow velocity in monocular retinoblastoma assessed by color doppler

OBJECTIVE:

To analyze the flow of retrobulbar vessels in retinoblastoma by color Doppler imaging.

METHODS:

A prospective study of monocular retinoblastoma treated by enucleation between 2010 and 2014. The examination comprised fundoscopy, magnetic resonance imaging, ultrasonography and color Doppler imaging. The peak blood velocities in the central retinal artery and central retinal vein of tumor-containing eyes (tuCRAv and tuCRVv, respectively) were assessed. The velocities were compared with those for normal eyes (nlCRAv and nlCRVv) and correlated with clinical and pathological findings. Tumor dimensions in the pathological sections were compared with those in magnetic resonance imaging and ultrasonography and were correlated with tuCRAv and tuCRVv. In tumor-containing eyes, the resistivity index in the central retinal artery and the pulse index in the central retinal vein were studied in relation to all variables.

RESULTS:

Eighteen patients were included. Comparisons between tuCRAv and nlCRAv and between tuCRVv and nlCRVv revealed higher velocities in tumor-containing eyes (p<0.001 for both), with a greater effect in the central retinal artery than in the central retinal vein (p=0.024). Magnetic resonance imaging and ultrasonography measurements were as reliable as pathology assessments (p=0.675 and p=0.375, respectively). A positive relationship was found between tuCRAv and the tumor volume (p=0.027). The pulse index in the central retinal vein was lower in male patients (p=0.017) and in eyes with optic nerve invasion (p=0.0088).

CONCLUSIONS:

TuCRAv and tuCRVv are higher in tumor-containing eyes than in normal eyes. Magnetic resonance imaging and ultrasonography measurements are reliable. The tumor volume is correlated with a higher tuCRAv and a reduced pulse in the central retinal vein is correlated with male sex and optic nerve invasion.     

Maternal ophthalmic artery doppler velocimetry in type 1 diabetes during pregnancy

Our purpose was to evaluate whether maternal ophthalmic artery pulsatility index (PI) in normotensive pregnancies with type 1 diabetes is different from that in normal normotensive pregnancies. The ophthalmic artery in 15 normal normotensive pregnant women, and 13 normotensive pregnant women with type 1 diabetes was studied once with colour Doppler flow imaging and pulsed Doppler ultrasonography after 16 weeks gestation. The heart rate, mean arterial blood pressure, and ophthalmic artery PI were calculated in each group. The PI (1.94 +/- 0.45) in normotensive pregnant women with type 1 diabetes was significantly lower than that (2.73 +/- 0.32) in normal normotensive pregnant women (P < 0.0001). There was no significant difference in maternal heart rate or mean arterial blood pressure between the two groups. These results suggest that vascular resistance in the maternal orbital circulation is reduced in pregnancies with type 1 diabetes that are normotensive. The lower PI in pregnant women with type 1 diabetes should be interpreted as orbital vascular vasodilatation, indicating orbital hyperperfusion or hyperaemia.     

Color Doppler Imaging of the orbital vessels

In ophthalmologic ultrasonography, Color Doppler Imaging (CDI) is a valuable method for detecting hemodynamic information in the central vessels of the retrobulb (ophthalmic artery, central retinal artery and internal carotid artery, etc.) and complementing the diagnosis of eye and eyeground view. Especially in diabetics, if orbital peripheral vascular resistance goes up with progress of diabetic retinopathy, the ophthalmic artery flow velocity wave form undergoes remarkable change, and the ratio of systolic mean velocity to diastolic mean velocity (mean S/D ratio) increases. On the other hand, if carotid obstruction and carotid advanced stenosis arise in sphagitides by the progress of macroangiopathy, the ophthalmic artery becomes the collateral pathway. Then, the flow directional reversal responsible for the collateral pathway is recognized and enters cerebral circulation and, as a result, the ophthalmic artery causes a fall in retinal circulation. As mentioned above, CDI in the ophthalmologic field plays a useful role not only in eyeground management, but in elucidation of the mechanism of ocular ischemic syndrome.