Retrobulbar blood flow changes in eyes with diabetic retinopathy a 10 year follow up study

Meira Neudorfer,1,* Rivka Kessner,1,* Dafna Goldenberg,1 Anat Lavie,1 Ada Kessler21Department of Ophthalmology, 2Radiology Ultrasound Unit, Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel*These authors contributed equally to this workPurpose: We sought to assess long-term changes in the flow parameters of retrobulbar vessels in diabetic patients.Methods: The retrobulbar circulation of 138 eyes was evaluated between 1994 and 1995 and 36 eyes were reevaluated between 2004 and 2008 (study group). They were divided into four groups: eyes of diabetic patients without diabetic retinopathy (DR), eyes with nonproliferative DR, eyes with proliferative DR, and eyes of nondiabetic patients (controls). Color Doppler imaging was used to assess the flow velocities in the major retrobulbar vessels. The resistive index (RI) was calculated and compared among the groups and between the two time periods.Results: RI values of the central retinal artery and posterior ciliary artery had increased in the two non-DR groups and in the nonproliferative DR group, with a surprising decrease measured in eyes with proliferative DR (P= nonsignificant [NS]). Combining the nonproliferative DR and proliferative DR groups resulted in a milder increase of the RI of the posterior ciliary artery (P= NS) and the central retinal artery (P=0.02) in the DR group compared to the other groups.Conclusion: Our results demonstrate that an increase of the resistance in the retrobulbar vessels, as a part of DR, can lessen over time and may even be reversed.Keywords: color Doppler imaging, diabetic retinopathy, retrobulbar blood flo