Preliminary results of magnetic resonance angiography of ophthalmic artery in diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Tian Qin ,  Shi Dapeng , Zhang Yanqiu , Guo Huili , Xu Xiaona

Henan Provincial Eye Hospital, Henan Institute of Ophthalmology, Zhengzhou 450003, China;

Corresponding author：

Shi Dapeng, Email: cjr.shidapeng@vip.163.com

Keywords：

Diabetic retinopathy/diagnosis; Ophthalmic Artery; Magnetic resonance angiography; Fluorescein angiography; Diagnostic imaging

DOI：

10.3760/cma.j.issn.1005-1015.2018.04.007

Video：

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ObjectiveTo observe the characteristics of magnetic resonance angiography of (MRA) ophthalmic artery in patients with diabetic retinopathy (DR).MethodsA total of 36 eyes of DR patients (DR group) diagnosed by clinical examination were included in the study. Among them, there were 42 eyes in 21 males and 15 eyes in 15 females. The average age was 55.2 years old. The average duration of diabetes was 7.56 years. All eyes were examined by MRA and fluorescein fundus angiography (FFA) in the ophthalmic artery. At the same time, 24 eyes of 12 patients were examined by computed tomography angiography (CTA). Twenty-two healthy volunteers with age and gender matching were selected as the control group. Among them, there were 13 males and 9 females. All patients underwent MRA examination of the ophthalmic artery; at the same time, 5 eyes of 5 eyes were examined by CTA. MRA and CTA were classified into three grades according to the development condition and shape change of the ophthalmic artery. 0 grade : no abnormality; grade Ⅰ: mild lesion; grade Ⅱ: obvious lesion. According to the results of FFA examination, it was divided into no obvious disease stage, background stage, proliferative stage, proliferative stage. The morphological features of the MRA of the ophthalmic artery in the DR group and the control group were compared. The relationship between the MRA grading of the ophthalmic artery and the FFA staging was observed in the DR group. The consistency analysis between the MRA and CTA grades of the ophthalmic artery in the DR group was performed by Kappa test; the relationship between the MRA grade and the FFA staging of the ophthalmic artery was analyzed by Spearson correlation analysis of the same data with two-way ordered attributes.ResultsIn 44 eyes of the control group, the MRA in grade 0 and Ⅰ of the ophthalmic artery were 41 and 3 eyes, respectively; all eyes of the CTA examination of the ophthalmic artery were grade 0. In 72 eyes of the DR group, the MRA in grade 0, Ⅰ, and Ⅱ of the ophthalmic artery were 28, 28, and 16 eyes, respectively. Among the 24 eyes examined by CTA, there were 13, 6, and 5 eyes in grade 0, Ⅰ, and Ⅱ, respectively. In the DR group, the classification of MRA and CTA of the ophthalmic artery was highly consistent (Kappa value = 0.86). There were significant differences in the number of eyes with different grades of MRA in the DR group and the control group (Z=-5.74, P=0.000). In 72 eyes of the DR group, there were 8, 12, 22, and 30 eyes in no obvious disease stage, background stage, proliferative stage, and proliferative stage, respectively. Correlation analysis showed that there was a significant correlation between MRA grading and FFA staging in the DR group (r=0.405, P=0.000).ConclusionsMRA can show the changes of ophthalmic artery morphology and reflect DR staging to a certain extent. It has a high consistency with FFA vascular changes.

Citation： Tian Qin, Shi Dapeng, Zhang Yanqiu, Guo Huili, Xu Xiaona. Preliminary results of magnetic resonance angiography of ophthalmic artery in diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2018, 34(4): 343-347. doi: 10.3760/cma.j.issn.1005-1015.2018.04.007 Copy

1.	王淑彬, 黎春雷, 邓又斌.糖尿病患者颈动脉、眼动脉及视网膜中央动脉的改变[J].中国医学影像技术, 2004, 20(4): 523-525.DOI: 10.3321/j.issn:1003-3289.2004.04.013.Wang SB, Li CL, Deng YB, et al.Detection of carotid artery, ophthalmic artery and central retinal artery changes in diabetic patients[J].Chin J Med Imaging Technol, 2004, 20(4): 523-525. DOI: 10.3321/j.issn:1003-3289.2004.04.013.
2.	Zhang T, Fan S, He W, et al. Ophthalmic artery visualization and morphometry by computed tomography angiography[J]. Graefe’s Arch Clin Exp Ophthalmol, 2015, 253 (4): 627-631. DOI: 10.1007/s00417-014-2896-8.
3.	陈军, 狄玉进, 张岩峰, 等. 3.0TMR多技术联合应用在头颈部动脉血管狭窄病变中的诊断价值[J].医学影像学杂志, 2010, 20(3): 321-324.Chen J, Di YJ, Zhang YF, et al. The combined application of Multi-technology at 3.0T MR in detecting stenosis of head and neck arteries[J]. J Med Imaging, 2010, 20(3): 321-324.
4.	Wilkinson CP, Ferris FL 3rd, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales[J]. Ophthalmology, 2003, 110(9): 1677-1682. DOI: 10.1016/S0161-6420(03)00475-5.
5.	Landis JR, Koch GG.The measurement of observer agreement for gategorical data[J]. Biometrics, 1977, 33(1): 159-174.
6.	袁中元, 武宝玉.微循环障碍与糖尿病慢性并发症[J].中国微循环, 2000, 4(2): 73-76.Yuan ZY, Wu BY. Microcirculation disorders and Chronic complications of diabetes[J]. J. of Chinese Microcirculation, 2000, 4(2): 73-76.
7.	Friedrich Y, Feiner M, Gawi H, et al. Diabetic papillopathy with macular star mimicking clinically significant diabetic macular edema[J]. Retina, 2001, 21(1): 80-82.
8.	Fujiok S, Karashima K, Saito Y. Evaluation of non-proliferative diabetic retinopathy with subgroups classified by orbital color Doppler imaging[J]. Nihon Ganka Gakkai Zasshi, 2009, 113(2): 95-100.
9.	姜士军, 罗海翔, 蒋燕玲. 糖尿病患者的眼动脉和视网膜中央动脉血流动力学改变[J]. 临床眼科杂志, 2006, 14(6): 494-495.DOI: 10.3969/j.issn.1006-8422.2006.06.004.Jiang SJ, Luo HX, Jiang YL.Study of the ophthalmic and central retina arteries blood flows for the diabetespatients[J].JClinOphthalmol, 2006, 14(6): 494-495.DOI: 10.3969/j.issn.1006-8422.2006.06.004.
10.	Zhang T, Fan S, He W, et al. Ophthalmic artery visualization and morphometry by computed tomography angiography[J]. Graefe’s Arch Clin Exp Ophthalmol, 2015, 253(4): 627-631. DOI: 10.1007/s00417-014-2896-8.
11.	李刚, 王青云, 刘晓.三维时间飞跃法MR血管成像评价眼动脉解剖及变异[J].中国医学影像技术, 2009, 25 (12): 2321-2322.DOI: 10.3321/j.issn:1003-3289.2009.12.050.Li G, Wang QiY, Liu X.Three-dimensional time of flight MRA evaluation of anatomic variation of ophthalmic artery [J].Chin J Med Imaging Technol, 2009, 25 (12): 2321-2322. DOI: 10.3321/j.issn:1003-3289.2009.12.050.
12.	Terelak-Borys B, Skonieczna K, Grabska-Liberek I.Ocular ischemic syndrome-a systematic review[J].Med Sci Monit, 2012, 18(8): 138-144.
13.	李瑞, 赵鹏飞, 张晓洁, 等.基于CTA 及超声探讨颅内段颈内动脉狭窄与眼部动脉血流关系[J].临床和实验医学杂志, 2017, 16(13): 1267-1271.DOI: 10.3969/j.issn.1671-4695.2017.13.007.Li R, Zhao PF, Zhang XJ, et al.Association of carotid atherosclerosis and ocular arterial hemodynamics Based on the CTA and sonography[J].Journal of Clinical and Experimental Medicine, 2017, 16(13): 1267-1271. DOI: 10.3969/j.issn.1671-4695.2017.13.007.
14.	张亿倬, 韩继武, 黄玉玲.动脉硬化超声所见与危险因子及年龄的相关性[J].中国临床康复, 2005, 9(41): 34-36.DOI: 10.3321/j.issn:1673-8225.2005.41.016.Zhang YZ, Han JW, Huang YL.Correlation of the findings of ultrasonography with risk factors and age in arteriosclerosis[J].Chinese Journal of Clinical Rehabilitation, 2005, 9(41): 34-36.
15.	Erdogmus S, Govsa F. Accurate course and relationships of the intraorbital part of the ophthalmic artery in the sagittal plane[J]. Minim Invasive Neurosurg, 2007, 50(4): 202-208. DOI: 10.1055/s-2007-985862.
16.	Jiménez-Castellanos J, Carmona A, Castellanos L, et al. Microsurgical anatomy of the human ophthalmic artery: a mesoscopic study of its origin, course and collateral branches[J]. Surg Radiol Anat, 1995, 17(2): 139-143.
17.	Perrini P, Cardia A, Fraser K, et al. A microsurgical study of the anatomy and course of the ophthalmic artery and its possibly dangerous anastomoses[J]. J Neurosurg, 2007, 106(1): 142-150. DOI: 10.3171/jns.2007.106.1.142.

1. 王淑彬, 黎春雷, 邓又斌.糖尿病患者颈动脉、眼动脉及视网膜中央动脉的改变[J].中国医学影像技术, 2004, 20(4): 523-525.DOI: 10.3321/j.issn:1003-3289.2004.04.013.Wang SB, Li CL, Deng YB, et al.Detection of carotid artery, ophthalmic artery and central retinal artery changes in diabetic patients[J].Chin J Med Imaging Technol, 2004, 20(4): 523-525. DOI: 10.3321/j.issn:1003-3289.2004.04.013.
2. Zhang T, Fan S, He W, et al. Ophthalmic artery visualization and morphometry by computed tomography angiography[J]. Graefe’s Arch Clin Exp Ophthalmol, 2015, 253 (4): 627-631. DOI: 10.1007/s00417-014-2896-8.
3. 陈军, 狄玉进, 张岩峰, 等. 3.0TMR多技术联合应用在头颈部动脉血管狭窄病变中的诊断价值[J].医学影像学杂志, 2010, 20(3): 321-324.Chen J, Di YJ, Zhang YF, et al. The combined application of Multi-technology at 3.0T MR in detecting stenosis of head and neck arteries[J]. J Med Imaging, 2010, 20(3): 321-324.
4. Wilkinson CP, Ferris FL 3rd, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales[J]. Ophthalmology, 2003, 110(9): 1677-1682. DOI: 10.1016/S0161-6420(03)00475-5.
5. Landis JR, Koch GG.The measurement of observer agreement for gategorical data[J]. Biometrics, 1977, 33(1): 159-174.
6. 袁中元, 武宝玉.微循环障碍与糖尿病慢性并发症[J].中国微循环, 2000, 4(2): 73-76.Yuan ZY, Wu BY. Microcirculation disorders and Chronic complications of diabetes[J]. J. of Chinese Microcirculation, 2000, 4(2): 73-76.
7. Friedrich Y, Feiner M, Gawi H, et al. Diabetic papillopathy with macular star mimicking clinically significant diabetic macular edema[J]. Retina, 2001, 21(1): 80-82.
8. Fujiok S, Karashima K, Saito Y. Evaluation of non-proliferative diabetic retinopathy with subgroups classified by orbital color Doppler imaging[J]. Nihon Ganka Gakkai Zasshi, 2009, 113(2): 95-100.
9. 姜士军, 罗海翔, 蒋燕玲. 糖尿病患者的眼动脉和视网膜中央动脉血流动力学改变[J]. 临床眼科杂志, 2006, 14(6): 494-495.DOI: 10.3969/j.issn.1006-8422.2006.06.004.Jiang SJ, Luo HX, Jiang YL.Study of the ophthalmic and central retina arteries blood flows for the diabetespatients[J].JClinOphthalmol, 2006, 14(6): 494-495.DOI: 10.3969/j.issn.1006-8422.2006.06.004.
10. Zhang T, Fan S, He W, et al. Ophthalmic artery visualization and morphometry by computed tomography angiography[J]. Graefe’s Arch Clin Exp Ophthalmol, 2015, 253(4): 627-631. DOI: 10.1007/s00417-014-2896-8.
11. 李刚, 王青云, 刘晓.三维时间飞跃法MR血管成像评价眼动脉解剖及变异[J].中国医学影像技术, 2009, 25 (12): 2321-2322.DOI: 10.3321/j.issn:1003-3289.2009.12.050.Li G, Wang QiY, Liu X.Three-dimensional time of flight MRA evaluation of anatomic variation of ophthalmic artery [J].Chin J Med Imaging Technol, 2009, 25 (12): 2321-2322. DOI: 10.3321/j.issn:1003-3289.2009.12.050.
12. Terelak-Borys B, Skonieczna K, Grabska-Liberek I.Ocular ischemic syndrome-a systematic review[J].Med Sci Monit, 2012, 18(8): 138-144.
13. 李瑞, 赵鹏飞, 张晓洁, 等.基于CTA 及超声探讨颅内段颈内动脉狭窄与眼部动脉血流关系[J].临床和实验医学杂志, 2017, 16(13): 1267-1271.DOI: 10.3969/j.issn.1671-4695.2017.13.007.Li R, Zhao PF, Zhang XJ, et al.Association of carotid atherosclerosis and ocular arterial hemodynamics Based on the CTA and sonography[J].Journal of Clinical and Experimental Medicine, 2017, 16(13): 1267-1271. DOI: 10.3969/j.issn.1671-4695.2017.13.007.
14. 张亿倬, 韩继武, 黄玉玲.动脉硬化超声所见与危险因子及年龄的相关性[J].中国临床康复, 2005, 9(41): 34-36.DOI: 10.3321/j.issn:1673-8225.2005.41.016.Zhang YZ, Han JW, Huang YL.Correlation of the findings of ultrasonography with risk factors and age in arteriosclerosis[J].Chinese Journal of Clinical Rehabilitation, 2005, 9(41): 34-36.
15. Erdogmus S, Govsa F. Accurate course and relationships of the intraorbital part of the ophthalmic artery in the sagittal plane[J]. Minim Invasive Neurosurg, 2007, 50(4): 202-208. DOI: 10.1055/s-2007-985862.
16. Jiménez-Castellanos J, Carmona A, Castellanos L, et al. Microsurgical anatomy of the human ophthalmic artery: a mesoscopic study of its origin, course and collateral branches[J]. Surg Radiol Anat, 1995, 17(2): 139-143.
17. Perrini P, Cardia A, Fraser K, et al. A microsurgical study of the anatomy and course of the ophthalmic artery and its possibly dangerous anastomoses[J]. J Neurosurg, 2007, 106(1): 142-150. DOI: 10.3171/jns.2007.106.1.142.

Chinese Journal of Ocular Fundus Diseases

Preliminary results of magnetic resonance angiography of ophthalmic artery in diabetic retinopathy

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