Analiza zmian w parametrach przepływu krwi u chorych z jaskrą w badaniu ultrasonografii dopplerowskiej w kolorze
Analysis of Blood Flow Parameters Alterations in Glaucoma Patients in Color Doppler Ultrasonography Examination
Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
Kierownik: prof. dr hab. n. med. Danuta Karczewicz
Summary: The aim of the review was to assess the characteristics of blood flow alterations in retrobulbar circulation in glaucoma patients (GL).
Clinical material included 2 groups of examined patients: 58 primary open angle glaucoma patients (POAG) – 58 eyes, 58 patients with age band 60-73; mean age 69.87 (SD ± 0.26). Control group (CG) consisted of 56 volunteers, mean age 68.5 (SD ± 5.44) and was matched according to sex and age with studied group.
Methods in ophthalmic examination, there was performed: visual acuity, slit lamp examination of the anterior segment of the eye and indirect ophthalmoscope examination of eye fundus. Intraocular pressure measurement was made with applanation tonometer. Patients with longstanding course of glaucoma (POAG) confirmed by additional ophthalmic examination results were qualified to studies. CDU of the external and internal carotid arteries and vertebral arteries was performed in all participants. Measurement of blood flow was performed in the following retrobulbar arteries: ophthalmic artery, central retinal artery, and two branches – lateral (LPCA) and medial (MPCA) – of the posterior ciliary artery. Peak systolic velocity (cm/s), end-diastolic velocity (cm/s), mean velocity (cm/s), pulsatility index, and resistance index were determined. CDU was performed with a Voluson scanner equipped with a transducer (7.5-10.0 MHz). The following statistical tests were used: Shapiro-Wilk, Levene’s, Spitvoll-Stoline, Student’s t-test, Mann-Whitney U, and analysis of variance (ANOVA).
Results: In glaucoma patients in all retrobulbar arteries (OA, CRA, LPCA and MPCA) significant decrease of mean blood flow velocity parameters PSV, EDV, MV and increase of average PI, RI indices were confirmed in comparison to control group, especially expressed in CRA and in PCAs (p ≤ 0.01).
Conclusions: In glaucoma patients statistically significant decrease of ocular blood flow expressed in retinal and choroidal circulation was shown. Noted alterations might imply the presence of disregulation and/ or autoregulation disturbances in retrobulbar circulation including vasospasm or mechanical compression on the wall of small vessels in response to permanent increase of intraocular pressure.
Słowa kluczowe: ultrasonografia dopplerowska w kolorze (CDU), parametry przepływu krwi, tętnice pozagałkowe, jaskra.
Keywords: color Doppler ultrasonography, blood flow parameters, retrobulbar parameters, glaucoma.