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AIM: To quantify early changes of macular capillary parameters in type 2 diabetic patients using optical coherence tomography angiography(OCTA).METHODS: Retrospective case study. A total of 49 healthy subjects, 52 diabetic patients without retinopathy(noDR)patients, and 43 mild nonproliferative diabetic retinopathy(mNPDR)patients were recruited. Capillary perfusion density, vessel length density(VLD), and average vessel diameter(AVD)were calculated from macular OCTA images(3 mm×3 mm)of the superficial capillary plexus after segmenting large vessels and the deep capillary plexus. Parameters were compared among control subjects, noDR, and mNPDR patients. The area under the receiver operating characteristic curve estimated the abilities of these parameters to detect early changes of retinal microvascular networks.RESULTS: Significant differences were found in the VLD and AVD among the three groups(P<0.001). Compared with the control group, the noDR group had significantly higher AVD(P<0.05). VLD of both layers in patients of mNPDR group was significant decreased compared with that of noDR group(all P<0.01). Deep AVD had a higher area under the curve(AUC)of 0.796 than other parameters to discriminate the noDR group from the healthy group. Deep AVD had the highest AUC of 0.920, followed by that of the deep VLD(AUC=0.899)to discriminate the mNPDR group from the healthy group.CONCLUSIONS: NoDR patients had wider AVD than healthy individuals and longer VLD than mNPDR patients in both layers. When compared with healthy individuals, deep AVD had a stronger ability than other parameters to detect early retinal capillary impairments in noDR patients.
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Background and objectives: Port-wine stains are defined as congenital benign vascular lesions. The treatment of port-wine stains remains a challenge, worldwide. This study aimed to analyze the histological characteristics in different types of port-wine stains and provide guidance for clinical decision-making. Methods and materials: Biopsies were from the hospital from 2015 to 2021. H&E staining, Immunofluorescence staining, Masson’s trichrome staining and Weigert staining were performed on the tissues. Results: A total of 35 port-wine stains patients were included in the study of four distinct types, namely red port-wine stains (11 cases), purple port-wine stains (seven cases), hypertrophic port-wine stains (nine cases) and nodular port-wine stains (eight cases). The mean vessel diameter of the different types was 38.7 ± 5.9 ?m, 93.5 ± 9.7 ?m, 155.6 ± 21.8 ?m and 155.6 ± 29.54 ?m, respectively. Mean vessel depth was 396.4 ± 31 ?m, 944.2 ± 105.4 ?m, 2,971 ± 161.3 ?m and 3,594 ± 364.6 ?m, respectively. The vessels in red port-wine stains, purple port-wine stains and hypertrophic port-wine stains were mainly composed of capillary and venous malformations, whereas those in nodular port-wine stains were venous or arteriovenous malformations. Limitation: The main limitation of the current study was the small number of patients. Conclusion: As the disease progresses, vessel diameters become larger, the vessel wall becomes thicker and vessels were found in a greater depth. A treatment plan should be scientifically formulated keeping in mind the histological characteristics of port-wine stains.
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Objective:To investigate the value of ultrasound findings in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus and correlate it with clinical factors.Methods:A total of 535 patients with type 2 diabetes mellitus who received treatment in Taiyuan Second People's Hospital from January 2016 to June 2019 underwent color Doppler ultrasound examination (T2DM group). Vascular inner diameter, intima-media thickness, atherosclerotic plaque formation, lumen stenosis or occlusion, and hemodynamic characteristics were determined in patients with type2 diabetes mellitus compared with those in 107 patients with non-type 2 diabetes mellitus (non-T2DM group). These parameters were correlated with the course of the disease, blood glucose level, concomitant hypertension or not, and clinical Wagner grade.Results:The incidences of intima-media thickening, atherosclerotic plaque, stenosis, and occlusion of lower extremity arteries were 69.9%, 89.0%, 77.0% and 11.6% respectively, in the T2DM group, which were significantly higher than 41.1%, 78.5%, 72.0%, and 1.9% respectively in the non-T2DM group ( χ2 = 32.52, P < 0.001; χ2 = 8.76, P = 0.003; χ2 = 27.77, P < 0.001). With the prolongation of the course of T2DM, the incidence of arterial lesions in the lower extremities increased ( P < 0.001). The incidences of intima-media thickening, atherosclerotic plaque, stenosis, and occlusion of lower extremity arteries were significantly greater in the poor blood glucose control group and non-hypertension group compared with the good blood glucose control group and hypertension group (all P < 0.05). The degree of lower extremity arterial stenosis in T2DM patients was related to Wagner's grade. As the degree of stenosis increased, Wagner's grade increased correspondingly and significantly ( P < 0.001). Conclusion:Color Doppler ultrasound examination has an important value in evaluating lower extremity arterial lesions in patients with T2DM. The degree of arterial lesions in the lower extremities of T2DM patients is correlated with the course of the disease, blood glucose levels, concomitant hypertension, and clinical Wagner grade. Color Doppler ultrasound examination has an important clinical significance in evaluating the degree of vascular lesions and guiding early interventions in the clinic.
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Purpose: To determine and validate retinal vascular caliber measurements by using the confocal scanning laser ophthalmoscopy system. Retinal vasculature changes are often regarded as clinical markers for systemic disease. Methods: It was a prospective observational study conducted on 600 eyes of 300 normal subjects with no systemic or ocular illness from January 1, 2016 to June 30, 2017 in a tertiary referral eye center. Non?mydriatic infrared reflectance, blue reflectance, and blue peak blue autofluorescence fundus imaging were done on the confocal scanning laser ophthalmoscopy system. The dimensions of the retinal vessels were measured using inbuilt calipers at 1800 ?m from the center of the optic disc. Internal and external dimensions were measured. Observer variation and its comparison using Image J software were assessed. Results: The median age was 29 years (18–50 years). Mean internal and external diameters for arterioles were 85.1 ± 12.4 ?m and 105.0 ± 12.0 ?m, and for venules were 133.8 ± 16.6 ?m and 145.4 ± 16.1 ?m, respectively. The mean internal and external wall thicknesses were 19.7 ± 8.0 ?m and 11.0 ± 5.6 ?m, and wall thickness?to?lumen ratios were 0.3 ± 0.1 and 0.1 ± 0.1, respectively. Arteriolar?to?venular ratio for lumen and vessel was 0.66 ± 0.1 and 0.74 ± 0.1, respectively. There was no statistically significant difference between age groups. Both inter? and intra?observer reproducibility was >95%. The Bland–Altman plot showed that the difference between measurements using both confocal scanning laser ophthalmoscopy and Image J software lies within the limits of agreement approximately 95% of the time. Conclusion: This is the first effort to develop a normative database by using a simple non?invasive confocal scanning laser ophthalmoscopy system with high observer reproducibility
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@#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.
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Objective To study the success experience of native arteriovenous fistula (AVF) operation,and provide a new reference range of blood vessel diameter for evaluating the success rate of AVF operation before surgery.Methods To proceed AVF operation to patients with 5 phase of chronic kidney disease,before surgery,patients should receive the vascular ultrasound and cardiac ultrasound to record the diameter of radio artery and cephalic vein along with the radio artery blood flow.Patients were divided into two groups:observation group(cephalic vein diameter< 2 mm)and control group(cephalic vein diameter > 2.0 mm). All those indexes examined before were re-examined 1 month after surgery. Except vessel diameter, the AVF blood flow velocity was also recorded. The range of the mature period was measured, along with the blood flow of each AVF 1 month after its initial use. The blood vessel diameter before surgery,the mature period of AVF and the blood flow on the machine of dialysis 1 month after the initial use were measured to evaluate the operation results of each group. Results In the observation group, 23 of the 25 patients showed the optimistic results. Unfortunately, 1 of the 2 pessimistic results showed the absence of vascular murmur,and the other one died of natural death before its initial use.The mature period of AVF for hemodialysis was(47.29 ± 2.45)d,significantly longer than that of control group (36.00 ± 1.29) d, and there was statistical difference (P<0.01). The blood flow of observation group showed no significant difference compared to that of control group (P > 0.05). Conclusions The patients with cephalic vein diameter<2.0 mm before operation needs a long mature period,but the blood flow after dialysis is not affected,and a good success rate is obtained.
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Objective We observed influence of different handgrip exercise on the changes of blood flow velocity and blood vessel diameter of basilic vein before and after the PICC placement and discuss the best model for handgrip exercise.Methods 60 patients with PICC were chosen and divided into group A,B and C with 20 patients in each groups.Group A received routine guidance on unarmed handgrip exercise,group B used electronic handgrip,the frequency was 25 times/min,the time period was 2 min with 4 times a day,once every 4 hours,group C adopted the same model as that of group B and 6 times a day,once every 3 hours.The venous blood flow velocity and blood vessel diameter was measured by pulsed Doppler ultrasound one hour before the PICC placement and one hour,1 day,3 days,7 days,10 days,14 days,21 days after placement.Results The venous blood flow velocity before and after PICC placement had statistically significant differences at different time points (F=2.934,P ＜ 0.05).The effect of group B and C was better than that of the group A and group C showed the best effect.The blood vessel diameter before and after PICC placement had significant differences at different time points(F=3.940,P ＜ 0.05).There was significant differences in the blood vessel diameter 1h before and 1h after PICC placement.Conclusions Handgrip exercise can effectively promote the upper limb venous blood flow velocity in patients with PICC,but shows little effect on the blood vessel diameter.Using the electronic hand grip in weak tap position,25 times/min,2 min every time,and 6 times a day (once every 3 hours),can obviously promote the upper limb venous blood flow velocity.
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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.
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Envejecimiento , Hipertensión , Fotograbar , Arteria Retiniana , Vena Retiniana , Retinaldehído , Humo , FumarRESUMEN
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.
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Humanos , Arteriolas , Presión Intraocular , Inyecciones Intravítreas , Edema Macular , Fibras Nerviosas , Fotograbar , Arteria Retiniana , Vasos Retinianos , Retinaldehído , Estudios Retrospectivos , Tomografía de Coherencia Óptica , Venas , BevacizumabRESUMEN
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.
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Humanos , Ojo , Glaucoma , Glaucoma de Ángulo Abierto , Glicosaminoglicanos , Glaucoma de Baja Tensión , Arteria Retiniana , Vasos Retinianos , Retinaldehído , Enfermedades Vasculares , VenasRESUMEN
Objective:To investigate the diagnosis value of Color Doppier Flow Imaging in the clinical application.Methods:Applying color doppier flow imaging was applied to 68 cases of hypertension.The carotid intima-media thickness,the intima-media thickness(IMT),RI,etc.were measured.The results wese compared with the figures healthy people of the same age.Results:The figures showed great difference,the blood vessel diameter and IMT of the patients aere obviously thicker than those of the healthy group(P
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Objective To observe the clinical results of carotid artery stenting in symptomatic high-risk old patients. Methods Twenty patients who were hospitalized between 1998 and 1999 with symptomatic carotid artery stenosis were studied,retrospectively. Mean age of the patients was 70 years. 90% of patients complicated with hypertension,hyperlipidemia and severe coronary artery diseases,35% with diabetes,and 75% with peripheral artery obstructive disease. Carotid artery angiogram showed 26 lesions,7 located at right /left common carotid artery,and 19 at right/left internal carotid artery. The percentage of lumen stenosis in all lesions was greater than 70%. The mean lesion length was (14.5?9.2) mm. Results Acute procedural success rate confirmed by angiogram was achieved in all patients (100%). The minimal lumen diameter was increased from (1.9?1.2) mm at baseline to (5.9?1.4) mm post stenting ( P
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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.
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Humanos , Arterias , Glaucoma , Glaucoma de Ángulo Abierto , Nervio Óptico , Retina , Arteria Retiniana , Vena Retiniana , Vasos Retinianos , Retinaldehído , VenasRESUMEN
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.