Zaburzenia przep造wu krwi u chorych ze zwyrodnieniem plamki zwi您anym z wiekiem widoczne w badaniu ultrasonografii dopplerowskiej w kolorze
Blood Flow Disturbances in Age-related Macular Degeneration 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 this review was to assess the characteristics of blood flow alterations in retrobulbar circulation in AMD patients.
Clinical material: included 2 groups of examined patients: 83 age-related macular degeneration patients (AMD) – 83 eyes, age range 57-86; mean age 70.61 (SD ± 7.65); 52 females (62.65%) and 31 males (37.35%). Control group (CG) consisted of 88 volunteers, age range 60-77; mean age 69.07 (SD ± 14.99); 52 females (62.5%) 36 males (40.9%) and was compared with age- and gender-matched glaucoma individuals.
Methods: In ophthalmic examination, the following tests were performed: visual acuity, slit lamp examination of the anterior segment of the eye and indirect ophthalmoscope examination of eye fundus. Measurement of intraocular pressure was made with an aplanatic tonometer. Patients with AMD confirmed by additional ophthalmic examination – Fluorescein angiography (AF) results were enrolled into 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 AMD patients, in all retrobulbar arteries (OA, CRA, LPCA i MPCA) significant decrease in 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 PCAs (p ≤ 0.01).
Conclusions: In AMD patients, statistically significant decrease in ocular blood flow expressed in retinal and choroidal circulation was shown, especially in choroid capillaries. Noted alterations might imply the presence of dysregulation and/or autoregulation disturbances in retrobulbar circulation including vasospasm of small vessels in choroidal circulation.
S這wa kluczowe: ultrasonografia dopplerowska w kolorze, parametry przep造wu krwi, t皻nice pozaga趾owe, zwyrodnienie plamki zwi您ane z wiekiem – AMD.
Keywords: color Doppler ultrasonography, blood flow parameters, retrobulbar parameters, age related macular degeneration – AMD.