Color doppler evaluation of the retrobulbar hemodynamic changes in chronic obstructive pulmonary disease

Cihan Çelik, Color Doppler evaluation of the retrobulbar hemodynamic changes in chronic obstructive pulmonary disease, Bülent Ecevit University, Faculty of Medicine, Radiology Thesis, Zonguldak, 2012In our study, evaluation of the hemodynamic changes in the ocular orbital vessels of the patients of the chronic obstructive pulmonary disease (COPD) by using color duplex doppler ultrasonography (CDDU) technique is aimed.60 patients who had chronic obstructive pulmonary disease (COPD) and a control group of 35 healthy volunteers included in this study. The peak systolic velocity (PSV), end-diastolic velocity (EDV), resistance index (RI) and pulsatility index(PI) measured at retrobulber area , in the ophthalmic artery (OA), central retinal artery (CRA), posterior ciliary artery (PCA ), using CDDU technique .Patients with COPD were grouped according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification.Patients were registered as group I (COPD stage 1: moderate airflow limitation), group II ( COPD stage :2 ingravescent airflow limitation) and group III (COPD stage 3: severe airflow limitation) . Measurements were performed in both of the eyes of each participant.A total of 95 people consisting of 60 patients who have age range 43-79 and average of age 65 and a control group of 35 healthy volunteers who have age range 49-79 and average of age 62 were included in the study. According to GOLD classification 20 patients in Group 1 (17 man,3 woman and average of age 65.1±8.2), 20 patients in Group 2 (17 man , 3 woman and average of age 63.8±8.3), 20 patients in Group 3 (17 man,3 woman and average of age 65.1±7.9) included in this study . Control group is consisting 35 persons(29 man , 6 woman and average of age 62.4±8.3) .The PI and RI measurements of the OA, CRA and PCA were significantly higher in Groups III compared to control group and the other groups. However, no significant differences were found in the ophthalmic artery (OA), central retinal artery (CRA), posterior ciliary artery (PCA ) for RI and PI values between control group with group I and group II . There were no significant differences between group I, group II, group III and control patients about PSVs and EDVs values of all arteries.There was no significiant difference between groups compared to the left and right eye.In COPD , ocular arteries may improve hemodynamic changes in stage III , these changes can be easily measured noninvasively and secure with CDDU .İn our study, a significant increase in PI and RI values of the OA , CRA and PSA is demonstrated in stage III COPD patients. An increase in the RI of the CRA, PCA reflected vasospasm that accompanies the peripheral small orbital arteries of COPD patients. This may be due to the effect of activated vascular mediators, which is the principal underlying mechanism of COPD.In addition, only patients with stage 3 COPD have increased orbital arters PI and RI values suggests that after a certain level of hypoxia and vascular mediators or duration of hypoxia and vascular mediators affect the hemodynamic changes in orbital arteries.Keywords: Colour duplex doppler ultrasonography; retrobulbar hemodynamic changes; chronic obstructive pulmonary disease