Whereas the anatomic result of vitrectomy in patients with vitreoretinal complications due to diabetes is usually satisfying, the functional outcome is sometimes poor. The authors investigated whether this may be related in part to effects of vitrectomy on ocular perfusion.
Ocular hemodynamics were measured before vitrectomy and 1 and 4 weeks postoperatively in 13 consecutive diabetic patients. Pulsatile choroidal blood flow was assessed with laser interferometric measurement of fundus pulsation amplitude. In addition, mean blood flow velocity and resistive index in the ophthalmic artery, the central retinal artery, and the posterior ciliary arteries were measured with color Doppler imaging.
Fundus pulsation amplitude was significantly reduced after surgery as compared to baseline (baseline: 3.7 ± 1.0 μm; 4 weeks: 3.1 ± 0.8;P < 0.001). Postoperatively, mean blood flow velocity in the central retinal artery (P = 0.009) and the posterior ciliary arteries (P = 0.0006) was significantly reduced, whereas resistive index was increased in the central retinal artery (P = 0.028) but not in the posterior ciliary arteries.
The current data suggest that vitrectomy induces significant reductions in ocular blood flow in patients with diabetic retinopathy. Whether this may affect the visual outcome after vitrectomy or whether this reflects improved retinal oxygenation after vitrectomy remains to be established.
Departments of *Ophthalmology and †Clinical Pharmacology, and ‡Institute of Medical Physics, University of Vienna, Austria.
Reprint requests: Andreas Wedrich, MD, Department of Ophthalmology, University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; e-mail: email@example.com
Presented in part as a poster at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO); May 4, 2000; Fort Lauderdale, Florida.
The study was carried out at the Department of Ophthalmology and the Department of Clinical Pharmacology, University of Vienna, Austria.
The authors have no proprietary or financial interest in any product mentioned in this article. The authors received no financial support for this study.