Kronik obstrüktif akciğer hastalığında orbital kan akım değişikliklerinin renkli doppler ultrasonografi ile değerlendirilmesi

Aim. The aim of this study is to investigate ocular hemodynamic affects of COPD, measuring ocular blood flow with Chronic Obstructive Pulmonary Disease (COPD). Method. Between 2009 and 2010 years, total of 80 patients with COPD staged by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria into four groups were enrolled in our study. Each group included 20 patients. Total of 63 healthy people selected randomly were accepted as control group. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) were calculated in the central retinal artery (CRA) and the ophthalmic artery (OA) respectively. The flow velocity of central retinal vein (CRV) was also measured. All of measurements were obtained for patients and control groups. Results. PSV and RI values of CRA and OA were significantly higher in the patient groups (p<0.05). But there was no statistically significance in EDV values (p>0.05). Furthermore significant increase of CRV measurements was detected (p<0.05). Conclusion. We thought that the changes of PSV and RI parameter in CRA and OA depend on hypoxia with COPD causes systemic and local inflammatory metabolites due to distortion of retinal auto regulatory mechanism. The elevation increase CRV is attributed to amount of blood return to the ophthalmic vein by means of ocular blood flow increase, and to the increased central venous blood pressure related to COPD.

Özet

Amaç. Kronik obstrüktif akciğer hastalığı (KOAH) olgularının oküler kan akım hızlarını ölçüp oküler hemodinaminin etkilenip etkilenmediğini saptamaktır. Yöntem. 2009-2010 yılları arasında Global Initiative for Chronic Obstructive Lung Disease (GOLD) kriterlerine göre değerlendirilerek 20’er kişilik 4 gruba ayrılan KOAH tanılı 80 hasta ve rastgele seçilen 63 sağlıklı birey olmak üzere toplam 143 olgunun Renkli doppler ultrasonografi (RDUS) tekniği ile santral retinal arter (SRA) ve oftalmik arter (OA) pik sistolik hızları (PSH), end diastolik hızları (EDH), rezistif indeksleri (Rİ) ve santral retinal ven (SRV) akım hızları ölçüldü. Bulgular. SRA ve OA PSH ve Rİ değerlerinde gruplarda anlamlı yükseklikler saptanırken (p<0,05) EDH değerlerinde istatistiksel olarak anlamlı yükseklik saptanmadı (p>0,05). SRV akım hızlarında anlamlı bir biçimde yükseklik saptandı (p<0,05). Sonuç. SRA ve OA’ya ait olan PSH ve Rİ parametrelerindeki değişikliklere; KOAH’ta meydana gelen hipoksi sonucu oluşan sistemik enflamasyonun ve lokal metabolitlerin retinanın otoregülasyon mekanizmasını bozarak sebep olduğunu düşünmekteyiz. SRV akım hızındaki artışı, oküler kan akımındaki artışa bağlı olarak oftalmik vene dönen akım miktarının artmasına ve KOAH’ta mevcut olan yüksek santral venöz basınca bağlamaktayız.

Anahtar sözcükler: Renkli Doppler ultrasonografi, oküler kan akımı, kronik obstrüktif akciğer hastalığı

 

Abstract

Aim. The aim of this study is to investigate ocular hemodynamic affects of COPD, measuring ocular blood flow with Chronic Obstructive Pulmonary Disease (COPD). Method. Between 2009 and 2010 years, total of 80 patients with COPD staged by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria into four groups were enrolled in our study. Each group included 20 patients. Total of 63 healthy people selected randomly were accepted as control group. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) were calculated in the central retinal artery (CRA) and the ophthalmic artery (OA) respectively. The flow velocity of central retinal vein (CRV) was also measured. All of measurements were obtained for patients and control groups. Results. PSV and RI values of CRA and OA were significantly higher in the patient groups (p<0.05). But there was no statistically significance in EDV values (p>0.05). Furthermore significant increase of CRV measurements was detected (p<0.05). Conclusion. We thought that the changes of PSV and RI parameter in CRA and OA depend on hypoxia with COPD causes systemic and local inflammatory metabolites due to distortion of retinal auto regulatory mechanism. The elevation increase CRV is attributed to amount of blood return to the ophthalmic vein by means of ocular blood flow increase, and to the increased central venous blood pressure related to COPD.

Keywords: Color Doppler ultrasonography, ocular blood flow, chronic obstructive pulmonary disease