Changes Of Ocular Hemodynamics Before And After Anti-VEGF Treatment In Patients With Retinal Vein Occlusion Detected By Color Doppler Ultrasound

Objective:1.The hemodynamic parameters of ophthalmic artery(OA),posterior short ciliary artery(PCA),central retinal artery(CRA),internal carotid artery(ICA)and central retinal vein(CRV)in patients with retinal vein occlusion(RVO)were measured by color doppler flow imaging(CDFI).To analyze the changes of ocular hemodynamics in patients with retinal vein occlusion(RVO).2.The hemodynamic parameters of ophthalmic artery(OA),posterior short ciliary artery(PCA),central retinal artery(CRA),internal carotid artery(ICA)and central retinal vein(CRV)in patients with retinal vein occlusion and macular edema(RVO-ME)after anti-VEGF treatment were measured by color doppler flow imaging(CDFI).To analyze the changes of ocular hemodynamics in patients with retinal vein occlusion and macular edema(RVO-ME)before and after anti-VEGF treatment.3.To investigate the characteristics and significance of ocular hemodynamics changes in patients with RVO and RVO-ME patients before and after anti-VEGF treatment by color doppler ultrasound.Methods:50 eyes(RVO group)were collected from patients with RVO in our hospital,all of them were monocular(27 cases in the right eye and 23 cases in the left eye).The diagnosis of RVO was confirmed by fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)was used to detect macular edema(25 cases were RVO-ME).Patients who are allergic to contrast agents,local anesthetics or mydriatic drugs,other fundus lesions,patients who have undergone eye surgery or laser treatment before,and patients with serious kidney disease,cardio cerebrovascular disease are excluded.The contralateral clinical healthy eyes of 50 RVO patients were taken as contralateral healthy eyes group.50 healthy persons in the same period were taken as the normal control group,26 cases in the left eye and 24 cases in the right eye of the control group were randomly selected as test eyes.The peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI)of OA,PCA,CRA and ICA and maximum blood flow velocity(Vmax)of CRV were obtained by color doppler ultrasound in each group.25 patients with RVO-ME were examined by color doppler ultrasound after anti-VEGF treatment,the PSV,EDV,RI of OA,PCA,CRA and ICA and Vmax of CRV were obtained.To compare the hemodynamic differences of internal carotid artery and ophthalmic vessels between RVO group,contralateral healthy eyes group,normal control group and RVO-ME patients before and after anti-VEGF treatment,and to analyze the characteristics and significance of ocular hemodynamics changes in patients with RVO and RVO-ME patients before and after anti-VEGF treatment by color doppler ultrasound.Results:1.Compared with the control group,the PSV and EDV of OA,PCA,CRA and ICA in RVO patients decreased,RI increased and CRV Vmax decreased significantly(P < 0.05).2.The PSV and EDV of OA,PCA and CRA in RVO eyes were lower than those in healthy eyes,but the difference was not statistically significant(P > 0.05);CRV Vmax in RVO eyes was lower than that of healthy eyes significantly(P < 0.05).There was no significant difference in RI of OA,PCA,CRA and ICA between RVO and contralateral healthy eyes.3.Compared with the normal control group,the PSV and EDV of OA,PCA,CRA and ICA in the contralateral healthy eyes group were significantly lower than those in the normal control group(P < 0.05);the RI of ICA in healthy eyes was higher than that in normal eyes(P < 0.05).There was no significant difference in RI of OA,PCA and CRA between contralateral healthy eyes group and normal control group.There was no significant difference in CRV Vmax between the contralateral healthy eyes group and the normal control group.4.After anti-VEGF treatment for 1 week,the hemodynamics of eyes and internal carotid artery had no significant change in RVO eyes with macular edema(RVO-ME).After 1 month of treatment,the PSV and EDV of CRA increased,RI decreased,and the Vmax of CRV increased significantly(P < 0.05).There was no significant difference in PSV,EDV and RI of OA,PCA and ICA between the eyes before and after treatment.Conclusion:1.The hemodynamics of internal carotid artery and ophthalmic vessels in both eyes of patients with retinal vein occlusion(RVO)will change,especially in RVO eyes.2.RVO-ME after anti-VEGF treatment,the duration of drug action will affect the hemodynamic changes of eyes after anti-VEGF treatment.One month after anti-VEGF treatment,the hemodynamics of RVO-ME eyes could be improved.The PSV,EDV,RI of CRA and Vmax of CRV were sensitive indexes to evaluate the therapeutic effect of anti-VEGF treatment in RVO-ME patients.3.Color doppler flow imaging(CDFI)has a high value in early detection of RVO and evaluation of therapeutic effect of RVO-ME.Because of its advantages of non-invasive,real-time,simple,repeatable and high diagnostic value,it provides a new method for clinical early diagnosis and evaluation of RVO treatment effect.