Variability of ultrasound indicators of retrobulbar blood flow in children with type 1 diabetes mellitus

Early diagnosis of eye blood supply disorders in patients with type 1 diabetes mellitus in childhood is an urgent task.

Determination of ultrasound changes in the hemodynamics of retrobulbar vessels under the influence of risk factors will have a beneficial effect on the dynamic monitoring of children and adolescents with type 1 diabetes mellitus.

Purpose of the study: to evaluate the variability of ultrasound indicators of retrobulbar blood flow in patients with type 1 diabetes mellitus in childhood and adolescence, depending on the duration of the disease, indicators of lipid metabolism and the level of glycated hemoglobin.

Material and methods. The study included data from 186 children aged 5–17 years, of which 148 had type 1 diabetes and 38 children in the control group. The analysis took into account the duration of type 1 diabetes mellitus, laboratory, ultrasound indicators and ophthalmological examination data.

Results. The results of the study confirm the presence of changes in the hemodynamics of retrobulbar vessels in type 1 diabetes mellitus in children in response to the influence of risk factors, and create conditions for the use of ultrasound studies in the assessment of disorders of the blood supply to the eye.

1. Biletskaya V.A., Lipatov D.V., Sayapina I.Yu. et al. Markers of proliferative diabetic retinopathy. Ophthalmology. 2022; 19 (3): 557–564. https://doi.org/10.18008/1816-5095-2022-3-557-564 (In Russian)

2. Dedov I.I., Shestakova M.V., Vikulova O.K. et al.Dynamics of epidemiological indicators of diabetes mellitus in the Russian Federation for the period 2017–2021: Collection of abstracts IX (XXVIII) National Diabetology Congress with international participation “Diabetes mellitus and obesity – non-infectious interdisciplinary pandemics of the 21st century”, September 05–08, 2022. Moscow, 2022. (In Russian)

3. Demidova T.Yu., Kozhevnikov A.A. Diabetic retinopathy: history, modern approaches to management, promising views on prevention and treatment. Diabetes Mellitus. 2020; 23 (1): 95–105. https://doi.org/10.14341/DM10273 (In Russian)

4. Kiseleva T.N., Zaitsev M.S., Ramazanova K.A., Lugovkina K.V. Possibilities of color duplex scanning in the diagnosis of vascular pathology of the eye. Russian Ophthalmological Journal. 2018; 11 (3): 84–94. https://doi.org/10.21516/2072-0076-2018-11-3-84-94 (In Russian)

5. Koshmeleva M.V., Samoilova Yu.G., Fomina S.V. et al. Glycemic variability indices as the basis for constructing a prognostic model for the development of diabetic complications. Molecular Medicine. 2023; 21 (6): 13–19. https://doi. org/10.29296/24999490-2023-06-02 (In Russian)

6. Screening for diabetic retinopathy: Improving effectiveness, maximizing benefit, and minimizing harm: Quick guide. Copenhagen: WHO Regional Office for Europe, 2021. License: CCBY-NC-SA3.0IGO (In Russian)

7. Kiseleva T.N., Zaitsev M.S., Lugovkina K.V. Safety issues of diagnostic ultrasound in ophthalmology. Ophthalmology. 2018; 15 (4): 447–454. https://doi.org/10.18008/1816-5095-2018-4-447-454 (In Russian)

8. Ultrasound examination in ophthalmology: A guide for doctors / Eds V.V. Neroev and T.N. Kiseleva. 1st ed. Moscow: ICAR; 2019. 324 p. (In Russian)

9. Divya K., Kanagaraju V., Devanand B. et al. Evaluation of retrobulbar circulation in type 2 diabetic patients using color Doppler imaging. Indian J. Ophthalmol. 2020; 68 (6): 1108–1114. https://doi.org/10.4103/ijo.IJO_1398_19

10. Khatri M., Saxena S., Kumar M. et al. Resistive index of central retinal artery is a bioimaging biomarker for severity of diabetic retinopathy. Int. J. Retina Vitreous. 2019; 5: 38. https://doi.org/10.1186/s40942-019-0189-4

11. Madhpuriya G., Gokhale S., Agrawal A. et al. Evaluation of Hemodynamic Changes in Retrobulbar Blood Vessels Using Color Doppler Imaging in Diabetic Patients. Life (Basel). 2022; 12 (5): 629. https://doi.org/10.3390/life12050629

12. Ozates S., Derinkuyu B.E., Elgin U. et al. Early Ophthalmic Artery Blood Flow Parameter Changes in Patients with Type 1 Diabetes Mellitus. Beyoglu Eye J. 2020; 5 (1): 17–21. https://doi.org/10.14744/bej.2020.15238

13. Wang Q., Zeng N., Tang H. et al. Diabetic retinopathy risk prediction in patients with type 2 diabetes mellitus using a nomogram model. Front Endocrinol (Lausanne). 2022; 13: 993423. https://doi.org/10.3389/fendo.2022.993423

14. Rao H., Jalali J.A., Johnston T.P., Koulen P. Emerging Roles of Dyslipidemia and Hyperglycemia in Diabetic Retinopathy: Molecular Mechanisms and Clinical Perspectives. Front. Endocrinol. (Lausanne). 2021; 12: 620045. https://doi.org/10.3389/fendo.2021.620045

15. Clinical Predictors of Diabetic Retinopathy Progression; A Systematic Review. Ghamdi AHA. Curr. Diabetes Rev. 2020; 16 (3): 242–247. https://doi. org/10.2174/1573399815666190215120435

16. Hainsworth D.P., Bebu I., Aiello L.P. Risk factors for retinopathy in type 1 diabetes: the DCCT/EDIC study. Diabetes Care. 2019; 42: 875–882. https://doi.org/10.2337/dc18-2308

17.