Predictive value of color Doppler imaging in an evaluation of retrobulbar blood flow perturbation in young type-1 diabetic patients with regard to dyslipidemia.

BACKGROUND: The aim was to examine blood flow velocity and vascular resistance in retrobulbar arteries in young type-1 diabetes (DM-1) patients. Statistical relationships between blood flow parameters and serum lipid levels (TCH, HDL, LDL, TG, ApoB) were also determined. MATERIAL/METHODS: Fifty-two eyes with diabetic angiopathy were examined (average age: 18.54 years). Color Doppler imaging (CDI) was performed in the ophthalmic (OA), central retinal (CRA), and temporal posterior ciliary (TPCA) arteries. The parameters PSV, EDV, MV, PI, and RI were compared with those of a control group (46 eyes). The Student's t, Shapiro-Wilk, and Mann-Whitney U statistical tests were used (p< or =0.01 and p< or =0.05 were considered significant). RESULTS: Significant decreases in PSV, MV, PI, and RI in the OA, CRA, and TPCA and negative correlations between TCH, LDL, and ApoB and decreased PI and RI in the OA as well as positive correlations between these parameters and EDV in the OA were found. Increased ApoB correlated with decreased PI and RI in the TPCA. There were no significant relationships between TG and HDL and the blood flow parameters. Elevated levels of HbA1c and dyslipidemia were confirmed. CONCLUSIONS: CDI is an effective method for detecting retinochoroidal circulation disorders in the early stage of diabetic angiopathy. The alterations in retrobulbar blood flow were characterized by significant decreases in PSV, MV, and RI in the CRA and PSV, MV, PI, and RI in the TPCA. Dysregulation of TCH, LDL, and ApoB was associated with vascular resistance fluctuation, mainly in the OA.

[Posterior capsule opacification as a complication of the posterior chamber intraocular lens implantation]. / Zmetnienie tylnej torebki soczewki jako powiklanie po wszczepach soczewki do komory tylnej.

PURPOSE: The aim of the study was to evaluate factors possibly effecting the posterior capsule opacification (PCO), after extra-capsular cataract extraction with the posterior chamber intra-ocular lens (IOL) implantation. Age of patients, refractive errors, technique of cataract extraction, intra- and postoperative complications and coexisting diseases were taken into consideration. In 1992-98 posterior laser Nd:YAG capsulotomy was performed in 222 eyes of 222 patients (134 women and 88 men) previously operated in 1st and IInd Eye Clinic. PCO occurred in 5.8% patients, who underwent cataract extraction in this period, in 5.7% patients operated with phacoemulsification method and in 5.8% patients where extra-capsular cataract extraction with nucleus expulsion was performed. PCO was diagnosed in 12.7% patients at the age below 30, in 17% aged 31-40, in 7.8% aged 41-55 and in 5.1% patients older than 55 years. Among the patients, who developed PCO, in 6.3% myopia was present, in 8% primary open angle glaucoma, 16.6% were treated for diabetes mellitus. In 7.6% eyes the intra-operative cortical clean up was not efficient. CONCLUSION: PCO occurred in young patients (under 40) twice as often as in the other groups of age. Technique of cataract extraction had an influence on the incidence of PCO as well.

[Changes in lens and retina and parameters of lipid metabolism and glycosylated hemoglobin levels in young patients with diabetes]. / Zmiany w soczewce i siatkówce a parametry gospodarki lipidowej i poziom hemoglobiny glikozylowanej u mlodych pacjentów chorych na cukrzyce.

PURPOSE: The aim of the work was, to find out the relations between the lipid profile and glycosylated hemoglobin in blood and eye changes in the diabetic young people. MATERIAL AND METHODS: There were 39 patients (19 women and 20 men), aged 14-27 years (mean 19.5), treated for diabetes during the period 6-23 years (mean 9.6). The ophthalmological examinations have included anterior segment and lens, as well as the fundus of the eye. There also have been made the blood serum examinations of cholesterol (CHC), LDL-CHC, HDL-CHC, trigliceride (TG), apolipoproteins B (ApoB) and glycosylated hemoglobin (HbA1c). RESULTS: Basing on these examinations it has been stated that: 1. the lens changes were observed in the patients of increased LDL-CHC level and ApoB, who suffered from diabetes shorter than 10 years, while in the patients suffering longer, lens changes correlate with the high level of HbA1c; 2. the eye fundus changes correlated substantially in the patients with the high levels of HbA1c, TG, HDL-CH (negatively), LDL-CH and ApoB, suffering less than 10 years; in the patients suffering longer, correlation was also with the increased level of HbA1c, CHC and LDL-CHC. 3. The increased levels of lipids were noted in the patients with the high level of HbA1c. CONCLUSIONS: The stated data have indicated, that the eye changes are caused by disturbances of lipid parameters, but besides of the glycaemia disorders. The diabetic duration does not matter for the lipid profile and HbA1c level, but it is important for the occurrence of eye fundus changes. The HbA1c essentially influences on the occurrence of eye fundus changes, but in the longer suffering patients, also on the lens changes. The high HbA1c level shifts the lipid profile towards atherogenic factors. It is purposeful, to decrease its level below 7%, which is accepted as good diabetes control.

[The endothelin-1 level in blood serum of patients with primary open angle glaucoma abd its influence on the static perimetry abd Gdx changes]. / Poziom endoteliny-1 we krwi pacjentów z jaskra pierwotna otwartego kata oraz jej wplyw na wystepowanie zmian w perymetrii statycznej i GDx.

PURPOSE: The aim of the work was to define the relationships between the endothelin-1 level in blood serum of glaucoma patients concerning the visual field defects and the number of nerve fibers. MATERIAL AND METHODS: 24 women and 14 men, aged 38-74 year (mean 53.4 year) with primary open angle glaucoma, without any systemic diseases. The control group consisted of 20 healthy women and men, aged 34-70 year (mean 52.6 year). The endothelin-1 level was tested with the enzymo-immunologic method from the blood serum. The visual field defects were examined with the Humphrey static perimetry. The nerve fibers were analyzed with the Gdx apparatus. RESULTS: Mean value of ET-1 in blood serum were similar in both examined groups, it was 0.51 in group of glaucoma patients and 0.54(fmol/l) in the control group. There were no significant correlations between ET-1 level, static perimetry, GDx parameters and age in the group of patients with POAG. The statistics significances were stated for ET-1 level and MD-parameter in static perimetry (p < 0.03) and ET-1 level with The Number--the GDx parameter (p < 0.03). CONCLUSION: There was no significant level of ET-1 in blood serum in group of patients with POAG. There have not been stated any relationships between the static perimetry and GDx changes in patients with POAG to endothelin-1 level in blood serum. It is the preliminary communication.