Aim: Aim of the study is to evaluate the ocular blood flow haemodynamics in patients with diabetes mellitus with no ocular symptoms and comparison of the same with normal controls by Doppler imaging.

Materials and Methods: Colour Doppler evaluation of 73 diabetic patients (146 eyes) and 73 healthy controls (146 eyes) were done with Voluson GE machine with High frequency probe (7.5 Mega Hertz). Doppler spectral analysis of ophthalmic arteries (OA) and central retinal arteries (CRA) were done.  The peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI) and S/D ratio were calculated. PSV, EDV, RI were measured in normal controls and in diabetics in both the eyes and they were compared. Differences within the groups were evaluated by paired-t- test. A value of less than 0.05 were considered as statistically significant.

Results: The average mean RI of CRA in controls on right side is 0.71+/- 0.02 and 0.69+1-0.02.on left side.  The average mean RI of OA in controls on right side is 0.77+1-0.15 and   0.76 +1- 0.02. on left side. In diabetics the average mean RI of CRA on right side is 0.77+1- 0.03. and   0.76+/-0.11 on left side. The average mean RI of OA in diabetics on right side is 0.79 +1-0.02 and 0.79 +1- 0.23 in left side. The PSV of CRA in diabetics was significantly reduced (p=<0.05) when compared to controls. The EDV of CRA in diabetics was also significantly reduced (p=<0.05) compared to normal controls. The RI is significantly increased compared to normal controls (p=<0.05). 95% confidence interval is observed in PSV, EDV, RI of CRA in diabetics. The PSV, EDV and RI of OA has no significant difference between normal controls and diabetics.

Conclusion: There were statistical significant difference between the PSV, EDV and RI of CRA in normal and in diabetics. This significant difference could be due to the circulatory changes in blood vessels in diabetics. No significant difference was made in OA between normal controls and in diabetics. This study concludes that retinal haemodynamic changes were present even before the clinical manifestations of retinopathy in diabetics

Keywords: Colour Doppler, diabetes, central retinal artery, ophthalmic artery, haemodynamics, resistance.

1. Lieb WE. Flaharty PM, HOA, Sergott RC. Acta ophthalmol 1992 (204); 50 -4. Colour Doppler imaging of eye and orbit. A synopsosis of 400 cases experience.
2. Dudea SM, M.ed ultrason 2011 jun 13 (2) 171-4. Ultrasonography of eye and orbit.
3. T subakimori.s, Fukuda M. Colour Doppler imaging of orbital vessels. Rinsho Byori Feb 55(2) 170-8..
4. Baydar s, Ad.apinar B, Kebapci N etal. Australia Radio!, 2007 June 51 (3) 230-5 colour Doppler ultrasound evaluation of orbital vessels in diabetic retinopathy.
5. Arai T, Num.ata K, Tanaka K, etal J ultrasound med. 1998 Nov; 17(11): 675 — 81.
6. Krasnicki P., Mariak Z, ustymowicz, proniewska-skretek E. " Assessment of blood flow in the ocular circulation in type 2 DM with colour Doppler imaging" klin oczna 2006; 108 (7-9); 294-8.
7. n JR, MCKillop G,0 Brienc, swa K, Nelson P. Acta ophthalmol scand, 2000 Aug;386-9 Colour Doppler imaging of the ocular circulation in diabetic retinopathy.
8. Gracner T. Ophthalmologica 2004 jul-aug; 218 94); 237-42. Ocular blood flow velocity determined by colour Doppler imaging in diabetic retinopathy.
9. JIANG shi Jun, Luo Hai — xiang, JIANG. Yan — ling. Journal of clinical ophthalmology 2006 -06. Study of ophthalmic and central retinal arteries blood flow for the diabetic patients.
10. Gil Hernandez MA, Abrerk Reyes P, Quintero M, Ayala E arch SOC ESP oftalmol. 2001 mar, 76 (3) 175 — 80 . Doppler ultrasound in type 1 diabetes.
11. Tamaki Y, Nagahara M, Yamashita H. Kikuchi M. Nippon Ganka Gakkai Zasshi 1993; 97 (8); 961-966. Analysis of blood flow velocity in OA by colour Doppler imaging.
12. Galina dimitrova. European ophthalmic review 2011, 5 (1); 16-9 colour Doppler imaging of ocular and orbital blood vessels in retinal disease.
13. JIANG shi Jun, Luo Hai-xiang Yan-ling ; Journal of clinical ophthalmology 2006- 06;' Study of ophthalmic and central retinal arteries blood flow for diabetic patients.
14. Ma Jialian, Yin Yiniin, chen Wei etal. Journal of Xi'an Medical university (chineese) 1999-01. The changes of ocular and orbital haemodynamics in patients with diabetes.
15. ZHANG Gai-ying. SHIMIow, GONG Li-xin etal ; Journal of medical imaing 2006-07; Study of haemodynamics of eye fundus blood vessel in patients with diabetes mellitus with colour Doppler flow trnatna.
16. NIE FANG, TONG Min-hui, CHE Yan.Journal of medical imaging 2005-11. Colour Doppler ultrasonoraphic study on haemodynarnic alteration of optic artery branches in patients with diabetes mellitus.
17. Gosling RG, DunbarG, King DH etal.The quantitative analysis of occlusive orbital disease by a nonintrusive ultrasonic technique. Angiology 22;52,1971
18. Guven D, Ozdemir H, Hasanreisoglu B; Haemodynamic alterations in diabetic retinopathy. Ophthalmology 103; 1245,1996.
19. Fake GT, Buzney SM, Ogasawara Hetal. Retinal circulatory abnormalities in type 1 diabetes. Invest ophthalmol vis sci 35;2968,1994.
20. GUO Haifang, LIU shandy .China Medical Herald 2009- 11.Haemodynamics study of colour Doppler ultrasound to central artery of retina of diabetics.

Sumeena Shanmugam

Asst Professor, Department of Radiodiagnosis