The Clinical Study Of Ocular Hemodynamic Changes About Diabetic Retinopathy Before And After Panretinal Photocoagulation

Objectives By studying the changes of peak systolic velocity with the central retinal artery and the posterior ciliary artery,electroretinogram,and the vision about diabetic retinopathy patients before and after panretinal photocoagulation,and compared with the normal people,we explored the treatment effects of retinal laser photocoagulation and the applications of color doppler flow imaging(CDFI) in the diabetic retinopathy(DR),so that the patients with diabetic retinopathy can receive more scientific therapy.Methods Consulting the diagnostic standard of type 2 diabetes from the WHO in 1999,collected in February 2013 to February 2014 in Anyang Eyes Hospital of DR hospitalized 60 cases(120 eyes) admitted in ophthalmology.The study objects were examined by indirect ophthalmoscope and fundus fluorescein angiography,conform to the diagnosis standard of diabetic retinopathy(Ⅲ～Ⅳstage). All of the patients were diagnosed without the disease of hypertension, cataract, ametropia,and so on. Ocular blood flow velocity of the 55 normal people(110 eyes) and the 60 patients(120 eyes) was examined by CDFI of CRA and PCAs using the PHILIPS HD6,PSV was recorded.The laser photocoagulation was operated by the same senior doctor,once a week,a total of four times.The examination of CDFI,electroretinogrm and the vision were performed in pre-operation,first postoperative day,7th day,1st month,3rd month,6th month. All the date were analyzed through the statistical software (SPSS 13.0). Statistical significance was set at P<0.05.Results The PSV of CRA in group HC was 10.36 ± 1.47cm/s,the PSV of CRA in group DR on the pre-operation,the first postoperative day,the 7th day,the 1st month,the 3rd month,the 6th month were 8.25 ± 0.86cm/s,9.71±1.42cm/s,8.84±1.03cm/s,7.14± 0.75cm/s,7.52±0.83cm/s,7.62±1.07cm/s.Compared the data of the group DR before and after retinal laser photocoagulation to the data of the group HC,there was significant difference,q=20.77,6.40,14.96,31.70,27.96,26.97,P<0.01.Compared the data of the group DR after retinal laser photocoagulation with the data before retinal laser photocoagulation,there was significant difference, q=14.69,5.94,11.17,7.35,6.34,P<0.01. The PSV of PCAs in group HC was 11.83±1.64cm/s,the PSV of PCAs in group DR at pre-operation,the first postoperative day,the seventh day,the 1st month,the 3rd month,the 6th month were 10.13±1.25cm/s,11.46±1.47cm/s,9.84±1.36cm/s,10.21±1.19cm/s,9.78 ±1.37cm/s,10.05±1.42cm/s.Compared the data of the group DR before and after retinal laser photocoagulation to the data of the group HC, there was significant difference, q=13.48、2.93、15.78、12.85、16.26、14.12,P<0.05.Compared the data of the group DR after retinal laser photocoagulation with the data before retinal laser photocoagulation, q=10.79,2.35,0.65,2.84,0.65, there was significant difference in the first postoperative day, P<0.01,there was no significant difference in the seventh day,the 1st month,the 3rd month,the 6th month,P>0.05.The aA of ERG in group HC was 78.17±11.72 μv,the aA of ERG in group DR at pre-operation,the first postoperative day,the seventh day,the 1 st month,the 3rd month,the 6th month were 34.48±6.72 μv,19.52±7.04 μ v,22.91 ±6.58μ v,25.83±5.64μv,26.12±4.35μv,25.93±3.73μv,Compared the data of the group DR before and after retinal laser photocoagulation to the data of the group HC,there was significant difference,q=67.92,91.18,85.91,81.37,80.92,81.21,P<0.01.Compared the data of the group DR after retinal laser photocoagulation with the data before retinal laser photocoagulation,q=23.78、18.39,13.75、13.29、13.59,P<0.01,the difference was obvious.The aT of ERG in group HC was 16.92±4.71ms,the aT of ERG in group DR at pre-operation,the first postoperative day,the seventh day,the 1st month,the rd month,the 6th month were 18.39±4.01ms,19.36±4.87ms,18.81 ±4.08ms,18.54±4.15ms,18.92± 3.76ms,19.06±4.08ms,Compared the data of the group DR before and after retinal laser photocoagulation to the data of the group HC,there was obvious difference, q=3.71,6.15,4.77,4.09,5.04,5.40,P<0.05.Compared the data of the group DR after retinal laser photocoagulation with the data before retinal laser photocoagulation,there was no significant difference,q=2.50,1.08,0.39,1.37,1.73,P>0.05.The bA of ERG in group HC was 172.16±46.38μ v,the bA of ERG in group DR at pre-operation,the first postoperative day, the seventh day,the 1st month,the 3rd month,the 6th month were 57.21±16.29 μv,38.44± 12.02μv,39.22±13.13 μv,43.29±15.81μv,45.23±12.78 μv,44.97±11.52 μ v,Compared the data of the group DR before and after retinal laser photocoagulation to the data of the group HC,there was significant difference,q=58.18,67.68,67.29,65.23,64.25, 64.38,P<0.01.Compared the data of the group DR after retinal laser photocoagulation with the data before retinal laser photocoagulation,q= 9.71,9.31,7.20,6.20,6.33, P<0.01,the difference was obvious.The bT of ERG in group HC was 38.91+6.13ms,the bT of ERG in group DR at pre-operation,the first postoperative day,the seventh day,the 1 st month,the 3rd month,the 6th month were 42.16 ± 8.47ms,44.49±9.21ms,43.67±10.03ms,44.02± 10.28ms,43.17±8.04ms,41.56±7.17ms,Compared the data of the group DR before and after retinal laser photocoagulation to the data of the group HC,there was obvious difference, q=4.04,6.94,5.92,6.35,5.30,3.30,P<0.05.Compared the data of the group DR after retinal laser photocoagulation with the data before retinal laser photocoagulation,there was no significant difference,q=2.96,1.92,2.37,1.28,0.76,P>0.05. Vision was improved to different degrees or remained the same after 6 mongths follow-up.Vision of 49 cases(98 eyes) improved 1 to 3 rows,the effective rate was 81.67%.Vision of 11 cases(22 eyes) unchanged.Conclusions1. Peak systolic velocity of the central retinal artery and the posterior ciliary artery about diabetic retinopathy patients after retinal laser photocoagulation increased transiently and then fell to below that of pre-operation.Retinal laser photocoagulation is a effective treatment to diabetic retinopathy patients,which can reduce the peak systolic velocity of the central retinal artery,improve and stabilize condition,protect visual function in long-term clinical effect.2. Color doppler flow imaging can observe the changes of ocular vessel flow velocity in diabetic’eyes noninvasive, repeatable and in real time,providing a basis for clinical treatments.