Objective To observe the effect of lowering intraocular pressure(IOP) treatment on ocular hemodynamics in patients with nonarteritic anterior ischemic optic neuropathy (NAION). Methods A total of 68 patients with NAION (68 eyes) were enrolled in this study. The patients were randomly divided into treatment group (38 eyes of 38 patients) and control group (30 eyes of 30 patients). All the patients were received methylprednisolone pulse therapy (200 mg, three days), vasodilator therapy with intravenous infusion of Xueshuantong solution (300 mg), optic nerve nutritional therapy with mouse nerve growth factor (30 mu;g) and acupoint injection in temporal with compound anisodine (2 ml). The total course was 10 days. The patients of treatment group received IOP lowering treatment to reduce the IOP to ge;8 mm Hg (1 mm Hg=0.133 kPa) or in a 30% reduction. The patients of control group received no IOP lowering treatment. The peak systolic velocity (PSV), pulsatility index (PI) and resistance index (RI) of ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (PCA) before and after treatment were comparatively analyzed by color doppler flow imaging. Results The differences of PSV (t=1.023, 1.145, 0.569), PI (t=0.679, 0.956, 1.634) and RI (t=0.816, 1.657, 0.998) of OA, CRA and PCA before treatment in treatment group and control group were not statistically significant (P＞0.05). Compared with before treatment, PSV (t=3.150, 7.650, 3.520) and PI (t=2.420, 5.430, 7.650) of OA, CRA and PCA increased obviously (P＜0.05), RI of OA, CRA and PCA decreased obviously (t=5.320, 9.640, 18.360;P＜0.05) after treatment in treatment group. In control group, the differences of PSV (t=2.090, -2.550, -2.100) and PI (t=-2.310, -2.230, -4.490) of OA, CRA and PCA between before and after treatment were not statistically significant (P＞0.05); but the differences of RI of OA, CRA and PCA between before and after treatment was statistically significant (t=2.970, 2.160, 2.690;P＜0.05). Compared with control group, PSV (t=2.632, 2.135, 5.364) and PI (t=3.251, 2.432, 4.243) of OA, CRA and PCA increased obviously (P＜0.05), RI of OA, CRA and PCA decreased obviously (t=3.664, 2.938, 4.324;P＜0.05) after treatment in treatment group. Conclusion Lowering intraocular pressure treatment can improve the ocular hemodynamics in NAION patients.
Objective To study the relationship between central retinal thickness and retinal vascular filling state of patients with non-proliferative diabetic retinopathy (NPDR). Methods A total of 248 diabetic patients without retinopathy or with NPDR in the hospital were enrolled in the study. Only the right eye of these patients were examined by optical coherence tomography (OCT), fundus fluorescein angiography (FFA), color Doppler flow imaging (CDFI). Patients with central retinal edema, hemorrhage and exudation were excluded from this study. Central retinal thickness was measured by OCT at the points of 1 mm, 1 to 3 mm, and 3 to 6 mm from the fovea. The patients were divided into retinal thickness normal, thinning and thickening groups according to their central retinal thickness. The normal range of central retinal thickness was defined as 216.4-304.9 μm in this study. The arm retinal circulation time and retinal arterial phase and venous phase (A-V) fluorescence filling time were recorded by FFA examination. The peak systolic velocity (PSV), pulsatility index (PI) and resistance index (RI) of ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) were measured by CDFI examination. The retinal fundus vascular filling state and ocular hemodynamic indexes were compared between different groups. Results The arm retinal circulation time of retinal thickness normal, thinning, thickening groups was (10.42±0.51), (10.36±0.64), (12.94±0.46) seconds respectively; the retinal A-V fluorescence filling time was (9.15±1.36), (6.36±1.15), (13.56±2.04) seconds. The difference of the arm retinal circulation time was statistically significant between the thickening and normal groups (t=1.93,P=0.04), and between the thickening and thinning groups (t=4.49,P=0.00). The retinal A-V fluorescence filling time was statistically significant between the thinning and normal groups (t=2.13,P=0.03), and between the thickening and normal groups (t=2.49,P=0.02), and between the thickening and thinning groups (t=5.38,P=0.00).The difference of PSV (t=3.290, -5.520, -4.900), PI (t=-4.310,-5.230, -4.390) and RI (t=4.970, 6.160, 5.990) of OA, CRA and PCA was statistically significant between the thickening and thinning groups (P＜0.05). Conclusion Central retinal thickness can affect the retinal vascular filling state of diabetic patients without retinopathy or with NPDR.