Hemodynamic parameters in the central retinal artery in active retinopathy of prematurity and their relationship with the central retinal vein

Purpose. To analyze the main hemodynamic parameters in the central retinal artery, as well as their relationship with hemodynamic indicators in the central retinal vein, depending on the stage and type of active ROP with the use of color duplex scanning. Material and methods. The 63 premature babies with various stages of active ROP and no signs of ROP were included in the study. The 55 children with active ROP included in the study were distributed according to the stages and type of disease course. All children were at the same gestational age at the time of examination – 37–38 weeks of postmenstrual age or at 6–11 weeks of life. For all these children were performed color duplex scanning of the vessels of the eye and orbit in the modes of color Doppler mapping and pulsed Doppler. Results. The study of the hemodynamic features of the central retinal artery in premature infants with active ROP showed that the progression of the disease was accompanied by a significant increase in blood flow velocity (Vsyst and Vdiast) with each subsequent stage of ROP. A higher index of peripheral vascular resistance is recorded in comparison with the non-progressive favorable type for children with an unfavorable course of the disease.The analysis of the ratio of the maximum blood flow velocities in the central retinal artery and central retinal vein made it possible to determine in which of the vessels the hemodynamic changes are most pronounced, depending on the stage and form of active ROP. Conclusion. Thus, there are statistically significant changes in such large vessels of the retinal bed as the central retinal artery and central retinal vein during active ROP. Color duplex scanning, having a significant diagnostic potential in assessing hemodynamic parameters, made it possible to obtain reliable information about the linear blood flow velocity and the state of peripheral resistance in the central retinal artery and their relationship with the central retinal vein. This information opens up prospects for improving the accuracy of predicting the nature of the course of the disease, especially i n the early stages. Keywords: color duplex scanning, active retinopathy of prematurity, hemodynamic parameters, central retinal artery, central retinal vein

Risk factors in central retinal vein occlusion: A multi-center case-control study conducted on the Italian population

Purpose To explore the risk factors for central retinal vein occlusion (CRVO) by comparing a large sample of patients with healthy controls. Materials and Methods Multi-center case-control study. The study group includes patients affected by central retinal vein occlusion, confirmed angiographically, aged 50 years old or above (Group A). The control group includes healthy subjects without an history of retinal vein occlusion (Group B). Outcome measures: age, gender, active smoking, presence of uncontrolled arterial hypertension (uHTN), presence of the following comorbidities: diabetes mellitus type II (DMII), chronic liver disease (CLD), chronic kidney disease (CKD), thyroid disease (TD), systemic lupus erythematosus (SLE), hyperhomocystenemia (HHcy), dyslipidemia (DLip), carotid artery disease (CAD), glaucoma, atrial fibrillation (AF), migraine headache (MH), chronic obstructive pulmonary disease (COPD), obstructive sleep apnea syndrome (OSAS), history of myocardial infarction (MI). Odds-ratios were calculated with logistic regression analysis. Results A total of 203 patients (Group A) and 339 controls (Group B). Statistically-significant differences were found for the following variables: age (OR: 1.109 [1.081–1.138], p < .001), active smoking (OR: 2.048 [1.210- 3.466], p < .008), DMII (OR: 4.533 [2.097–9.803], p < .001), HHcy (OR: 4.507 [2.477–10.001 ], p < .001), DLip (OR: 2.255 [1.352–3.762], p = .002), CAD (OR: 6.632 [2.944- 14.942], p < .001), glaucoma (OR: 4.656 [2.031–10.673], < .001), OSAS (OR: 1.744 [1.023–2.975], < .041), uHTN (OR: 3.656 [2.247–5.949], < .001). No statistically-significant differences were found for the other variables. Conclusions Older age, active smoking, as well as presence of DMII, HHcy, DLip, CAD, glaucoma, OSAS, and uHTN, all increase the risk for CRVO. A comprehensive assessment of patients with CRVO is paramount. Adequate control of all the aforementioned risk factors is likely of great significance in reducing the incidence of CRVO among the general population, and it likely plays an important role in improving the prognosis following the occlusive event.