1. 1

2. 2 The authors declare no conflicts of interest No financial support was taken for this prospective study

3. ASNR 2015 Annual Meeting Abstract No: EP-88 Submission Number: 1817 The evaluation of orbital blood flow changes in diabetic retinopathy with color doppler ultrasonography Sevgi Unal 1, Fahri Halit Besir 1, Ramazan Buyukkaya 1, Yusuf Aydin 2, Murat Kaya 3, Handan Ankarali 4 1 Department of Radiology, Duzce University Faculty of Medicine, Duzce, Turkey 2 Department of Endocrinolgy, Duzce University Faculty of Medicine, Duzce, Turkey 3 Department of Ophthalmology, Duzce University Faculty of Medicine, Duzce, Turkey 4 Department of Statistics, Duzce University Faculty of Medicine, Duzce, Turkey 3

4. Purpose The incidence of diabetes mellitus (DM) currently is increasing in developed countries. The individuals of DM is increasing life expectancy with the modern treatment methods. Accordingly, the incidence of diabetic retinopathy (DR)which most common cause of blindness is increasing in the 20-65 age group.

5. Purpose Orbital changes associated with diabetic retinopathy can be detected by color Doppler ultrasonopgraphy before developmented anatomic pathology. We aimed to investigation of the changes in ocular blood flow in patients with diabetes mellitus by color doppler US and investigation of the contribution of color doppler US in early diagnosis of diabethic retinopathy.

6. Materials and Methods The present study included 80 patients with diabetes mellitus and 42 healthy controls aged between 35 and 65 years. Exclusion criteria: previous eye surgery glaucoma ocular inflammatory disease non-diabetic vascular disease history

7. Materials and Methods The study groups were defined as follows: Group 1: Healthy volunteers were classified as the control group. Group 2: Patients with DM had no eye problems without refractive problems Group 3: Patients with non-proliferative diabetic retinopathy (there are microaneurysms, intraretinal hemorrhage, retinal edema, hard and soft exudates findings in eye examination) Group 4: Patients with non-proliferative diabetic retinopathy (there are optic disc and retinal neovascularization and retinal traction findings or laser photocoagulation history in eye examination)

8. Materials and Methods Color doppler US examination were examined with a Siemens Acuson Anteres scanner with a 5-12 MHz linear-array transducer. The peak systolic velocity ( PCV), mid diastolik velocity (MDV ), end diastolic velocity ( EDV), the resistive index (RI),and pulsatility index (PI) values ​​ were measured by examining the ophthalmic artery (OA), central retinal artery (CRA), central retinal vein (CRV ) and posterior ciliary artery (PCA ) by color doppler US examination. Results were compared between the control groups and diabetic groups.

9. In this study, we evaluated 42 healthy volunteers (Group 1), 32 patients in group 2, 33 patients in group 3, and 15 patients in group 4. All of the participants were between the ages of 35 and 65 years with mean ages of 50.9 ± 8.7 years. The significant differences of age, gender, fasting blood glucose, HbA1c, urea and DM duration were determined between groups (p<0.05) (table) In the evaluation of doppler examination, the covariance statistical analysis was performed for eliminating the effects of these differences Results

11. Ophthalmic artery PCV and MDV are found significantly higher in group 1. RI is found significantly higher in group 4 than group 1. Central retinal artery PI is found significantly lower in group 2 than group 1 and group 3. Posterior ciliary artery PCV is found significantly higher in group 1 and group 3 than group 2. RI is found significantly higher in group 2 than DM groups with retinopathy (group 3 and 4). Results

14.  In our study, it was observed that affected more orbital arterial system in the diabetic patient.  It was no observed that affected the orbital venous system.  Resitive index is an objective value is affected in patients with advanced disease.  In the literature, the PCV of CRA and OA PSH were found less than in the diabetic patients. In addition, the RI of OA was found more higher in the diabetic patients. Conclusions

15.  In the literature, the PCV of CRA and OA PSH were found less than in the diabetic patients. In addition, the RI of OA was found more higher in the diabetic patients. Conclusions

16.  In a conclusion, color doppler US which is easy and inexpensive technique examination results show variations especially in patients with non-retinopathy and early stage retinopathy and Color doppler US can be used as a noninvasive test in early diagnosis of diabetic retinopathy. But, long-term follow-up studies with more participants are needed. Conclusions

17. Mac Kinon J, McKillop G, O’Brien C, Swa K, Butt Z, elson P. Colour Doppler Imaging of The Ocular Circulation in Diabetic Retinopathy. Acta phthalmol Scan 2000; 78;386-389. Goebel W, Lieb WE, Ho A, Sergott RC, Farhoumand R, Grehn F: Color Doppler imaging: a new tecnique to assess orital blood flow in patients with diabetic retinopathy: Invest Ophthalmol Vis Sci 1995; 36: 864-870. Mendivil A, Cuartero V, Mendivil MP: Ocular blood flow velocities in patients with proliferative diabetic retinopathy and healthy volunteers: a prospective study. Br J Ophthalmol 1995;79:413-416. References