ObjectiveTo observe the hemodynamic parameters of retrobulbar vessels of eyes with primary open-angle glaucoma (POAG) by using color Doppler imaging (CDI) technique. Methods Pertinent publications were retrieved from the PubMed of The National Library of Medicine, the ISI Web of Knowledge of The Institute for Scientific Information, and Cochrane Central Register of Controlled Trials. Case control studies involved POAG patients were included. Changes in retrobulbar blood flow parameters including peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary artery (SPCA) were evaluated by CDI. The searching time was from the data base established up to April, 2014. Meta analysis was used on the included articles, the mean difference (MD) along with 95% confidence interval (95% CI) of the blood flow parameters were calculated. ResultsTwenty-four articles were retrieved, including 1336 eyes as cases, 1102 eyes as controls. PSV of POAG eyes was statistically signiflcantly lower than controls in the OA (MD=-3.05, 95%CI:-4.49--1.61, P < 0.001), CRA (MD=-1.66, 95%CI:-1.95--1.38, P < 0.001), SPCA (MD=-0.87, 95% CI:-1.49--0.26, P=0.005). EDV of POAG eyes was statistically significantly reduced than controls in the OA (MD=-1.78, 95%CI:-2.14--1.41, P < 0.001), CRA (MD=-0.95, 95%CI:-1.17--0.74, P < 0.001), SPCA (MD=-0.53, 95%CI:-0.71--0.36, P < 0.001). Statistically significant increases in RI of POAG eyes than controls in the OA (MD=0.04, 95%CI: 0.03-0.05, P < 0.001), CRA (MD=0.06, 95%CI: 0.05-0.07, P < 0.001), SPCA (MD=0.04, 95%CI: 0.03-0.06, P < 0.001). ConclusionThis meta-analysis suggests that significant decreased velocity and increased resistance of retrobulbar blood flow are found in POAG eyes.
ObjectiveTo observe the diagnostic sensitivity and specificity of color Doppler flow imaging (CDFI) for persistent hyperplastic primary vitreous (PHPV). MethodsThe clinical data of 71 children (93 eyes) with congenital cataract which suspected of concurrent PHPV were retrospectively analyzed. The children included 45 males (54 eyes) and 26 females (39 eyes), aged from 1 to 24 months, with an average age of (7.6±4.3) months. All eyes were examined by CDFI, and observe whether there was a pathological strip in the vitreous, the site of the connection between the strip echo and the wall of the eye and the signal of blood flow on the strip echo. Within 1 week after a CDFI examination under general anesthesia, 64 children (79 eyes) underwent lens excision combined with vitrectomy and the other 14 eyes of 7 children underwent mydriatic fundus examination by two experienced eye specialists. Combined with clinical features of PHPV, the diagnosis and differential diagnosis were made according to the clouding of the lens, posterior capsule proliferation, vitreous proliferation and retinal detachment position which were found during operation and fundus examination. Compare and analyze the CDFI examination results and the above diagnosis results, calculate the sensitivity and specificity of CDFI for PHPV. ResultsIn surgery and mydriatic fundus examination results of 93 eyes, vitreous abnormal in 85 eyes, no significant changes were found in vitreous of the other 8 eyes. In 85 eyes of abnormal vitreous, 68 eyes were diagnosed as PHPV, 16 eyes were diagnosed as familial exudative vitreoretinopathy (FEVR), and 1 eye was diagnosed as treactional retinal detachment. In 85 eyes of abnormal vitreous which were found by surgery and fundus examination, CDFI confirmed 81 eyes and its diagnostic sensitivity was 95.3%; the other 4 eyes were not found vitreous abnormality, and the missed diagnosis rate was 4.7%. Surgery and mydriatic fundus examination found no vitreous abnormal in 8 eyes, but CDFI explored strip low echo connected with the optic disc or posterior lens capsule in vitreous. In the 68 eyes of PHPV which were diagnosed by surgery or fundus examination, 59 eyes had the same diagnosis of CDFI, the sensitivity of CDFI was 86.8%; PHPV was not diagnosed in 25 eyes by surgery or fundus examination, but only 8 eyes were also not diagnosed by CDFI, and the specificity of CDFI was 32.0%. The remaining 17 eyes were diagnosed as FEVR in 16 eyes and traction retinal detachment in 1 eye after surgery or mydriatic fundus examination, but they were all diagnosed as PHPV in CDFI. The misdiagnosis rate of CDFI was 68.0%. ConclusionFor PHPV, the diagnostic sensitivity and specificity of CDFI are 86.8% and 32.0%, respectively.