Changes of microvascular diameter in non-proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the changes of microvascular diameter in non-proliferative diabetic retinopathy(NPDR)at different stages.<p>METHODS: Prospective case-control study. Patients with type 2 diabetes mellitus complicated with diabetic retinopathy(DR)who were hospitalized in the Endocrine Department of our hospital from September 2020 to March 2021 were selected and divided into diabetic non-retinopathy group(50 cases and 50 eyes), DR stage Ⅰ group(50 cases and 50 eyes), DR stage Ⅱ group(50 cases and 50 eyes), DR stage Ⅲ group(50 cases and 50 eyes)according to the “Clinical Diabetic Retinopathy Disease Severity Scale” formulated by the Chinese Medical Association in 1985. In addition, 50 cases and 50 eyes of a control group with normal physical examination were selected, totally 250 cases and 250 eyes. The fundus color photos were taken and entered into the ARIA1.0 automatic analysis software to record the diameters of arterio-venous and capillary vessels in different ranges, with 4 segments in each range and 200 segments in each group for statistical analysis.<p>RESULTS: There was no significant difference in the diameter of retinal artery between different stages of NPDR(<i>P</i>>0.05), and there was significant difference in the diameter of retinal vein and diameter of perimacular capillary amorg different stages of NPDR(<i>P</i><0.05). The multiple comparison of retinal vein diameter and perimacular capillary diameter in different groups was statistically significant(<i>P</i><0.01). The average score of retinal vein diameter in the range of 0-0.5PD was “stage Ⅲ course > stage Ⅱ course>stage Ⅰ course>normal group>control group”. The average score of retinal vein diameter group in the range of 0.5-1.0PD(including 0.5)was “stage Ⅲ course > stage Ⅱ course > stage Ⅰ course > normal group > control group”, the average score of perimacular capillary diameter group was “stage Ⅲ course > stage Ⅰ course > control group; Stage Ⅲ course > normal group; Stage Ⅱ course > stage Ⅰ course > control group; Stage Ⅱ course > normal group; The diseased normal group > the control group”, while there was no significant difference between the stage Ⅲ course and the stage Ⅱ course, the stage Ⅰ course and the diseased normal group(<i>P</i>>0.05).<p>CONCLUSION: Retinal artery diameter has no obvious change in NPDR stages. The retinal vein and perimacular capillary in diabetic patients are dilated. In different stages of NPDR, the diameter of the vein and perimacular capillary is gradually widened.

Analysis of Factors Associated with Retinal Vascular Caliber in Normal Korean Subjects

PURPOSE: To measure the diameter of the retinal arterial and venous caliber of normal Korean subjects and evaluate the factors affecting these diameters. METHODS: Fundus photography was performed on 152 normal Korean subjects. Central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) were measured with a computer-based program (IVAN), and were used to investigate the relationship between the diameter and factors including age, gender, hypertension, diabetes, and smoking. RESULTS: Among the study subjects, the CRVE was 209.33 +/- 12.40 microm and the CRAE was 149.70 +/- 9.01 microm. The CRVE and CRAE decreased with increasing age in all study subjects (both p 0.05). CONCLUSIONS: In our study group, retinal vascular caliber of normal Korean subjects decreased with aging. Retinal vascular caliber was affected by gender and hypertension, but not by smoking and diabetes.

The Effect of Bevacizumab on Retinal Vessel Diameter, Intraocular Pressure, Retinal Nerve Fiber Layer and the Optic Disc

PURPOSE: To evaluate the effects of a single intravitreal bevacizumab injection on retinal vessel diameter, intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness and the optic disc in patients with diabetic macular edema (DME). METHODS: In this retrospective study, 63 eyes with DME were included. All patients received an intravitreal injection of 1.25 mg bevacizumab. We reviewed retinal vessel diameter, IOP RNFL thickness and vertical cup-to-disc (C/D) ratios at the baseline and 7 days, 1 month, 3 months and 6 months after injection. The diameter of the central retinal arteries and veins were measured using retinal photographs. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated using the revised Parr-Hubbard formula. RNFL thickness was obtained using optical coherence tomography. The vertical C/D ratio of the optic disc was evaluated using stereoscopic optic disc photography. RESULTS: After bevacizumab injection, the CRAE significantly decreased at 7 days and 1 month postoperatively compared to baseline (p < 0.001 and p = 0.036, respectively). However, the changes in the CRAE at 3 months and 6 months were not statistically significant (p = 0.992 and p = 0.342, respectively). There were no statistically significant changes in the CRVE, mean IOP, RNFL thickness and vertical C/D ratios of the optic disc. CONCLUSIONS: A single intravitreal bevacizumab injection transiently decreased the diameters of central retinal arterioles, but induced no significant changes in central venular diameter, mean IOP, RNFL thickness or vertical C/D ratios of the optic disc.

Comparison of the Central Retinal Vessel Diameter Between Glaucomatous and Normal Eye

PURPOSE:To compare the diameter of central retinal vessels between patients with normal-tension glaucoma, primary open-angle glaucoma and healthy (control) eyes. METHODS: The authors reviewed 30 eyes of 30 normal-tension glaucoma patients, 20 eyes of 20 primary open-angle glaucoma patients and 30 eyes of normal persons who had no systemic vascular diseases. The diameters of the central retinal arteries and veins were measured and calculated using a revised Parr-Hubbard formula, and results were compared between the groups. RESULTS: The diameter of the central retinal vessel showed no statistical differences between the eyes with normal-tension glaucoma and primary-open angle glaucoma. However, there were significant differences between the eyes of patients with glaucoma and the normal control eyes (p<0.05). Conclusion: The diameter of the central retinal vessels in glaucoma patients were narrower than that in the control group. Our results suggest that the diameter of the central retinal vessels may affect the development of glaucoma both in normal tension and primary open-angle types, or that glaucomatous damage may influence the diameter of the central retinal vessels.

Retinal Vessel Diameter: 1. Comparison of Normal and Glaucoma Eyes

Narrowing of the retinal vessels in chronic glaucoma has been recognized only recently. We performed this study to evaluate the vessel diameter in normal and glaucoma eyes, addressing whether the retinal vessel diameters differ with the degree of glaucomatous optic nerve damage. The diameters of the superior temporal and inferior temporal retinal artery and vein were measured at the optic disc border from optic disc photographs of 234 eyes of 141 patients with primary open-angle glaucoma and 139 eyes of 86 normal subjects. The photographic magnification was corrected according to Littmanns method. Only one eye per patient and subject was taken for statistical analysis. According to the neuroretinal rim/disc area ratio, the glaucoma group was divided into four stages(early; more than 0.61, medium; 0.60~0.41, advanced; 0.40~0.21, far advanced; less than 0.20). In the normal group the diameter of the inferior temporal vein(0.130+/-0.020mm) was the largest, followed by the superior temporal vein(0.117+/-0.017mm), the inferior temporal artery(0.102+/-0.016mm), finally the superior temporal artery(0.093+/-0.012mm). The retinal vessel diameter decreased significantly with decreasing of the neuroretinal rim/disc area ratio. In the glaucomatous eyes as compared to the normal eyes, the diameters of the inferior temporal and superior temporal retinal artery were significantly smaller at the early and medium stages(p<0.03, p<0.02, respectively). Whereas both inferior temporal and superior temporal retinal vein diameters were significantly samller at the far advanced stage(p=0.01, p=0.005, respectively). The results indicate that generalized reduction of the retinal vessel diameter throughout the retina is related to the severity of glaucoma. From a diagnostic point of view, evaluation of artery diameter rather than vein diameter may be helpful for the differentiation between normal and glaucomatous eyes.

Retinal Vessel Diameter: 2. Its Correlation with Glaucomatous Optic Nerve Damage

Generalized narrowing of the retinal vessels has been recognized for glaucomatous and nonglaucomatous optic neuropathies. To evaluate how closely peripapillary retinal vessel diameters were related to functional and structural optic nerve damage in primary open-angle glaucoma, the data of the vessel diameters were correlated with intra- and peripapillary morphometric parameters and visual field indices. The diameters of the superior temporal and inferior temporal retinal artery and vein were measured at the opticdisc border from optic disc photographs of 234 eyes of 141 patients with primary open-angle glaucoma and 139 eyes of 86 normal subjects. Only one eye per patient and subject was taken for statistical analysis. The diameters of the inferior temporal and superior temporal retinal artery were significantly correlated with the intrapapillary parameters, the peripapillary parameters and the visual field indices. The correlation coefficients were highest for the neuroretinal rim data (r>0.37, p=0.0001), followed by mean deviation, vertical cup to disc ratios, whereas total peripapillary atrophy data, zone beta and zone alpha data were relatively low. Concerning the vessel diameter, the highest correlation coefficients were calculated for the inferior temporal artery, followed by the superior temporal artery. No correlation was found with age and refraction. The results indicate that, in primary open-angle glaucoma, the vessel diameter redduces with decreasing area of the neuroretinal rim, increasing visual field defects and increasing peripapillary atrophy. Its evaluation can be helpful for the diagnosis of glaucoma and possibly also for follow-up.