Using Iris Angiography To Study Diabetes Pupil Dysfunctionen

PURPOSE：Using iris angiography(FA+ICGA) to study the relationshipbetween iris ischemia and diabetes pupil dysfunctionMETHODS: The outdepartment ophthalmic patients who have diabetesand are voluntary to take ocular angiography was included in the study,inSecond Hospital of Jilin University,from december2010to december2011.Excluding those who have disease or factors which may affect the ocularmicrocirculation or pupil function.All the patients were took slit lamp anteriorsegment and fundus examination, anterior segment and fundus color photo-graphy, fundus photography, fundus angiography (FA) and iris angiography(ICGA+FA). Using the Image tool software to process pupil images and it’smeasurement tools to measure pupil diameter, calculate the count of leakagepoint.The subjects were divided into two groups according to the size ofpupils.Dilated group:dilated pupil diameter of≥7mm, Small pupil group:dilated pupil diameter of <7. Difference between the two groups wear analysedto find the relationship between diabetic pupil function and iris ischemia.RESULTS:43subjects,86eyes was included in the study,51eyes ofdilated group,35eyes of small pupil group.Gender:dilated group have30female cases and21male cases,the small pupil group have20female cases and15male cases,no significant difference between two groups (χ2=0.024, P=0.877). Age:from32to69years-old, dilated group60year-old (56years old,65years old), small pupil group59-year-old(56years old,64years old),nosignificant difference between two groups (Z=-0.133, P=0.436). Durationof diabetes:0.5years to30years, dilated group9years (3years,13years),small pupil group10years (6years,11years),no significant difference betweentwo groups (Z=-0.291, P=0.771). Glycosylated hemoglobin:5.4%-14.8%,dilated group6.80%(6.10%,9.10%),small pupil group8.60%(6.30%,10.00%), no significant difference between the groups (Z=-1.849, P=0.064). Fundusangiography DR stage: dilated group:10eyes showed no abnormal ofretina(19.61%),20eyes of Phase I (39.22%),5eyes of Phase II(9.8%),14eyesof Phase III(27.45%),2eyes of Phase IV(3.92%),no one of Phase V;the smallpupil group:2eyes of Phase I(5.71%),2eyes of Phase II(5.71%),9eyes ofPhase III (25.71%),11eyes of Phase IV(31.43%),11eyes of V(31.43%);differences between the two groups was significant (χ2=39.379, P <0.001).Iris angiography leakage:dilated group:12eyes’ leakage is less than onequadrant(23.53%),7eyes’ leakage is1-2quadrants(13.73%),7eyes’ leakage is2-3quadrants(13.73%),25eyes’ leakage is3-4quadrants (49.02%). small pupilgroup:0eye’s leakage is less than one quadrants,4eyes’ leakage is1-2quadrants(11.43%),2eyes’ leakage is1-2quadrants(5.71%),29eyes’ leakage is1-2quadrants(82.86%). Differences between the two groups was significant (χ2=11.223, P <0.001). All the subjects have fluorescein leakage at pupil edge,including10eyes without fundus abnormal. The small pupil group’s leakage ismore severe than the dilated group.8eye of small pupil group have leakage ofiris stroma, neovascular plexus or dilated blood vessels can be found in thecorresponding region of ICGA.CONCLUSIONS:Iris angiography using FA and ICGA together is moreaccurate to assess iris vascular status than using one. Pupil dysfunction mayhave relationship with iris ischemia.Pupil dysfunction may have relationshipwith retinopathy.The anterior segment ischemia in diabetic patients may earlierthan posterior segment.Pupil dysfunction may be a early warning signs ofocular ischemic.Gender, age, duration of diabetes, blood glycose fluctuationhave little relationship with pupil dysfunction,in this research.