Initial color Doppler findings in retinal vein occlusion

Abstract

Purpose We assessed early hemodynamic characteristics of various types of retinal vein occlusion using color Doppler imaging and spectral analysis. Methods We measured the maximum systolic and diastolic blood flow velocities and the resistance index (RI) in the central retinal artery and the maximum and minimum blood flow velocities in the central retinal vein of affected eyes and contralateral unaffected eyes in 102 adults (63 men and 39 women; mean age, 61 ± 14.6 years) who presented with retinal vein occlusion. Sixty‐three control subjects (27 men and 36 women; mean age, 50 ± 22.1 years) were also investigated. Results No significant differences in hemodynamic characteristics were found between the control subjects' eyes and the patients' unaffected eyes. In the 18 cases of ischemic central retinal vein occlusion, the mean diastolic arterial flow velocity (p = 0.005) and venous flow velocity (p < 0.04) were lower and the mean RI was higher (p = 0.0002) in the affected eyes than in the unaffected contralateral eyes. In the 51 cases of nonischemic central retinal vein occlusion, the mean diastolic arterial flow velocity (p < 0.0001) and venous flow velocity (p < 0.0001) also were lower and the mean RI (p < 0.0001) was higher in the affected eyes than in the unaffected contralateral eyes. These variables were different in the ischemic versus nonischemic types of central retinal vein occlusion. In the 33 cases of branch retinal vein occlusion, no significant differences were observed in arterial or venous blood flow velocities in the affected versus unaffected eyes. The mean RI in the affected eyes was significantly higher (p = 0.009) in patients with central versus branch retinal vein occlusion. Conclusions These results suggest that previous arterial disorders were not involved in the pathogenesis of central retinal vein occlusion in these patients. The findings also support the value of Doppler imaging and spectral analysis in the diagnosis and evaluation of retinal vein occlusion and confirm the involvement of arterial flow in venous occlusion. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:28–33, 2000.

Retinal vascular oximetry during ranibizumab treatment of central retinal vein occlusion

“…Collateral capacity in symptomatic cases obviously does not suffice to ward off an increase in retinal venous pressure, venous dilation, retinal haemorrhage, retinal oedema and the occasional optic disc oedema. Studies have shown a reduction in retinal venous blood flow velocity using colour Doppler flowmetry,2 3 a reduction in capillary blood flow velocity on the Heidelberg retinal flow meter4 and an increased arteriovenous passage time on fluorescein and indocyanine green angiographies 5–7. Reduction of blood flow leads to retinal hypoxia8–10 and upregulation of vascular endothelial growth factor (VEGF),11 12 which would lead to vasodilation and hyperperfusion 13.…”

Follow up by colour Doppler imaging of 102 patients with retinal vein occlusion over 1 year

“…14 15 Arterial and venous flows are modified at the outset of the disease, and CDI helps in differentiating ischaemic from nonischaemic types of CRVO with a minimum velocity (CRVmin) in the central retinal vein of less than 2 cm/s in non-ischaemic types with a sensitivity of 0.67 and specificity of 0.65. 16 The effect of isovolaemic haemodilution is clearly demonstrated on arterial and venous velocities, with significant improvement from prehaemodilution to post-haemodilution velocities. 17 In a previous study we showed that eyes of patients without RVO and contralateral eyes in RVO patients are similar, with no difference in arterial and venous velocities, thus allowing us to use unaffected eyes as controls.…”

“…17 In a previous study we showed that eyes of patients without RVO and contralateral eyes in RVO patients are similar, with no difference in arterial and venous velocities, thus allowing us to use unaffected eyes as controls. 16 The natural course of RVO is long and unpredictable, with possible occurrence of ischaemia several months after onset of the disease. 3 18 Arterial and venous flow changes during this evolution remain unknown.…”

Colour Doppler Imaging of Ocular and Orbital Blood Vessels in Retinal Diseases

“…8,14,17 [27][28][29][30] and fellow eyes. [31][32][33][34] It has also been suggested that a characteristic decrease in the blood flow velocity in the central retinal vein was highly predictive of iris neovascularisation. 30 Most of the studies in eyes with CRVO that investigated arterial blood flow reported impaired blood flow parameters in the retrobulbar arteries, suggesting that altered arterial blood flow is involved in the pathogenesis of CRVO.…”

“…30 Most of the studies in eyes with CRVO that investigated arterial blood flow reported impaired blood flow parameters in the retrobulbar arteries, suggesting that altered arterial blood flow is involved in the pathogenesis of CRVO. [30][31][32][33][35][36][37][38] In branch retinal vein occlusion (BRVO), there have been reports of non-significant differences 34 …”