Nonproliferatif Diyabetik Retinopati ve Proliferatif Diyabetik Retinopati’de Optik Sinirin Shear-Wave Elastografi ile Değerlendirilmesi ve Santral Retinal Arter Rezistif İndeks Değerleri ile Karşılaştırılması

Öz

Amaç: Nonproliferatif diyabetik retinopatide ve Proliferatif diyabetik retinopatide optik sinir elastisitesini ve santral retinal arter rezistif indeks değerlerini karşılaştırmayı amaçladık.
Materyal ve Metod: Nonproliferatif diyabetik retinopatili ve Proliferatif diyabetik retinopatili 31 olgunun optik sinir sertlik derecesi Shear-Wave Elastografi tekniğiyle değerlendirildi. Eş zamanlı olarak Renkli Doppler Ultrasonografi yöntemiyle santral retinal arterin rezistif indeks değerleri ölçülerek, kontrol gru-buyla karşılaştırıldı.
Bulgular: Retinopatisi olan hastalar, retinopatisi olmayan diyabetik hastalar ve sağlıklı gönüllüler ile karşılaştırıldığında optik sinir Shear-Wave Elastografi değerleri anlamlı olarak yüksek izlendi(p<0.05).
Santral retinal arter rezistif indeks değerleri retinopatisi olan hastalarda olmayanlara göre anlamlı olarak yüksek izlendi(p<0,05). Retinopatisi olmayanlar için Rİ değerleri 0,57±0,88 ve Retinopatisi olanlarda ise 0,67±0,53 olarak ölçüldü.
Sonuç: Diyabetik retinopatinin etyopatogenezi hala tartışmalıdır. Nonproliferatif diyabetik retinopatide ve Proliferatif diyabetik retinopatide Shear-Wave Elastografi ile optik sinirin sertlik derecesinde ve Renkli Doppler Ultrasonografi incelemede oküler kan akım parametrelerinde anlamlı değişiklikler olabilmektedir.

Anahtar Kelimeler: Diyabetik Retinopati, Shear-Wave Elastografi, Optik sinir, Renkli Doppler Ultrasonografi , Santral retinal arter

Anahtar Kelimeler

• Diyabetik Retinopati
• Shear-Wave Elastografi
• optik sinir
• Renkli Doppler Ultrasonografi
• santral retinal arter

Evaluation of Optic Nerve With Shear-Wave Elastography and Comparing With Central Retinal Artery Resitive Index Values in Nonproliferative Diabetic Reti-nopathy And Proliferative Diabetic Retinopathy

Öz

Background: We aimed to compare optic nerve elasticity and central retinal artery resistive index values in Nonproliferative diabetic retinopathy and Proliferative diabetic retinopathy.
Materials and Methods: The degree of optic nerve hardness of 31 patients with nonproliferative diabetic retinopathy and proliferative diabetic retinopathy was evaluated using the Shear-Wave Elastography technique. Simultaneously, the resistive index values of the central retinal artery were measured using Color Doppler Ultrasonography and compared with the control group.
Results: Optic nerve Shear-Wave Elastography values were significantly higher in patients with retinopa-thy compared to healthy volunteers and diabetic patients without retinopathy(p<0.05).
Central retinal artery resistive index values were significantly higher in patients with retinopathy than those without retinopathy (p <0.05). RI values were measured as 0.57 ± 0.88 for those without retinopa-thy and as 0.67 ± 0.53 for those with retinopathy.
Conclusions: The etiopathogenesis diabetic retinopathy is still controversial. Significant changes in the degree of stiffness of the optic nerve and ocular blood flow parameters in Color Doppler Ultrasonography examination can be observed in Nonproliferative diabetic retinopathy and Proliferative diabetic retinopa-thy with Shear Wave Elastography.

Keywords: Diabetic Retinopathy, Shear-Wave Elastography, Optic nerve, Color Doppler Ultrasonogra-phy, Central retinal artery

Anahtar Kelimeler

• Diabetic Retinopathy
• Shear-Wave Elastography
• Optic nerve
• Color Doppler Ultrasonography
• Central retinal artery

Kaynakça

1. 1.İnan S. Diabetic Retinopathy and Etiopathogenesis. Kocatepe Medical Journal. 2014; 15(2): 207-17.
2. 2. Blodi FC. Eugene Wolff’s anatomy of the eye and orbit. Arch Ophthalmol. 1977; 95:1284.
3. 3. Taş S, Onur MR, Yılmaz S, Soylu AR, Korkusuz F. Shear-WaveElastography Is a Reliableand Repeatable Method for Measuring the Elastic Modulus of the Rectus Femoris Muscle and Patellar Tendon. J UltrasoundMed. 2017 Mar; 36(3):565-70.
4. 4. Sancak İT. Temel Radyoloji. Güneş Tıp Kitapevleri. 2015; 61-86.
5. 5. Dikici AS, Mihmanli I, Kilic F, Ozkok A, Kuyumcu G, Sultan P et al. In Vivo Evaluation of the Biomechanical Properties of Optic Nerve and Peripapillary Structures by Ultrasonic Shear Wave Elastography in Glaucoma. Iran J Radiol. 2016 Apr; 13(2):e36849.
6. 6. Asal N, Sayan CD, Gökçınar NB, Şahan MH, Doğan A, İnal M. Evaluation of the optic nerve using strain and shear-wave elastography in pre-eclampsia. Clinical Radiology. 2019; 74(10): 813.e1–813.e9.
7. 7. Thitaikumar A, Ophir J. Effect of lesion boundary conditions on axial strain elastograms: a parametric study. Ultrasound Med Biol 2007; 33:1463-7.
8. 8. He C, Sun Y, Ren X, Lin Q, Hu X, Huang X et al. Angiogenesis mediated by toll-like receptor 4 in ischemic neural tissue, Arterioscler Thromb Vasc Biol. 2013; 33:330-8.

9. 9. Rungger-Brandle E, Dosso AA, Leuenberger PM. Glial reactivity, an early feature of diabetic retinopathy, Invest Ophthalmol Vis Sci. 2000; 41:1971-80.
10. 10. Li L, Eter N, Heiduschka P. The microglia in healthy and diseased retina. Experimental Eye Research, 2015; 136:116-30.
11. 11. Khatri M, Saxena S, Kumar M, Chabbra AK, Bhasker SK, Akduman EI et al. Resistive index of central retinal artery is a bioimaging biomarker for severity of diabetic retinopathy. International Journal of Retina and Vitreous. 2019; 5:38.
12. 12. Basturk T, Albayrak R, Ulas T, Akcay M, Unsal A, Toksoy M, Koc Y. Evaluation of resistive index by color Doppler imaging of orbital arteries in type II diabetes mellitus patients with microalbuminuria. Ren Fail. 2012; 34:708–712.
13. 13. Koc M, Deniz N, Serhatlıoğlu S. Akut Santral Seröz Korioretinopatide Renkli Doppler Ultrasonografi ile Orbital Akım Parametrelerinin Değerlendirilmesi. Fırat Tıp Dergisi 2008; 13(2): 120-122.