{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:12:33Z","timestamp":1787170353247,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T00:00:00Z","timestamp":1650672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background\u2014Diabetic retinopathy is a common complication of long-standing hyperglycemia. Microangiopathy-induced retinal changes are well-visualized on ophthalmoscopic examination. However, certain hemodynamic alterations have also been documented in the diabetic population, which have not been completely understood. Aim\u2014To study the hemodynamic changes in retrobulbar circulation in diabetic patients with and without retinopathy, and to compare these changes with non-diabetic controls. Materials and Methods\u2014This hospital-based prospective study included 50 diabetic and 50 non-diabetic patients. The diabetic groups consisted of 25 patients without retinopathy and 25 patients with retinopathy, and were labeled as Groups I and II, respectively. All subjects underwent orbital color Doppler ultrasonography using a linear high-frequency probe. The color Doppler parameters (peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI)) were measured and recorded using the spectral waveform of the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCA). Comparison of obtained values was carried out using appropriate tests of significance. Results\u2014The resistive indices of the ophthalmic, central retinal, and short posterior ciliary arteries were significantly higher in diabetic patients compared to controls (p &lt; 0.001). The difference was also significant between Group I and Group II. Comparison of PSV and EDV of CRA and SPCAs among three groups using one-way ANOVA revealed a significant difference, with the highest blood flow velocities in the control group and the lowest in diabetics with retinopathy. The ophthalmic artery showed no significant change in blood flow velocity. Analysis using the Pearson correlation coefficient provided a positive correlation between the RI values of OA, CRA, and SPCA and the presence of diabetic retinopathy (OA = r 0.417, p &lt; 0.001; CRA = r 0.466, p &lt; 0.001; SPCA = r 0.438; p &lt; 0.001). Conclusions\u2014The resistive index of OA, CRA, and SPCA is a reliable indicator to assess diabetic-associated hemodynamic changes. The use of orbital color Doppler ultrasonography in diabetic patients can help in the identification of patients who are at risk of developing retinopathy.<\/jats:p>","DOI":"10.3390\/life12050629","type":"journal-article","created":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T21:39:45Z","timestamp":1650749985000},"page":"629","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Evaluation of Hemodynamic Changes in Retrobulbar Blood Vessels Using Color Doppler Imaging in Diabetic Patients"],"prefix":"10.3390","volume":"12","author":[{"given":"Gulshan","family":"Madhpuriya","sequence":"first","affiliation":[{"name":"Department of Radiodiagnosis, M.G.M. Medical College and M.Y. Hospital, Indore 452001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8532-3471","authenticated-orcid":false,"given":"Sudheer","family":"Gokhale","sequence":"additional","affiliation":[{"name":"Gokhale Sonography Clinic, Indore 452001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alka","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, M.G.M. Medical College and M.Y. Hospital, Indore 452001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakhar","family":"Nigam","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, M.G.M. Medical College and M.Y. Hospital, Indore 452001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3039-996X","authenticated-orcid":false,"given":"Yung-Liang","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.2337\/dc08-0342","article-title":"Ocular associations of diabetes other than diabetic retinopathy","volume":"31","author":"Jeganathan","year":"2008","journal-title":"Diabetes Care"},{"key":"ref_2","first-page":"254","article-title":"Ocular manifestations in diabetes, a hospital based prospective study","volume":"13","author":"Shrestha","year":"2011","journal-title":"Nepal. Med. Coll. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.5455\/jrmds.20153211","article-title":"A study on ocular manifestations of diabetes mellitus","volume":"3","author":"Kathiara","year":"2015","journal-title":"J. Res. Med. Dent. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2731","DOI":"10.2147\/OPTH.S269002","article-title":"Agreement on grading retinal findings of patients with diabetes using fundus photographs by allied medical personnel when compared to an ophthalmologist at a diabetic retinopathy screening program in nepal","volume":"14","author":"Thapa","year":"2020","journal-title":"Clin. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1016\/S2214-109X(20)30489-7","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The right to sight: An analysis for the global burden of disease study","volume":"9","author":"Steinmetz","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"815","DOI":"10.2337\/diacare.15.7.815","article-title":"Onset of NIDDM occurs at least 4\u20137 yr before clinical diagnosis","volume":"15","author":"Harris","year":"1992","journal-title":"Diabetes Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/S0161-6420(96)30514-9","article-title":"Hemodynamic alterations in diabetic retinopathy","volume":"103","author":"Ozdemir","year":"1996","journal-title":"Ophthalmology"},{"key":"ref_8","first-page":"864","article-title":"Color Doppler imaging: A new technique to assess orbital blood flow in patients with diabetic retinopathy","volume":"36","author":"Goebel","year":"1995","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_9","first-page":"385","article-title":"Blood velocity in the ophthalmic artery determined by color Doppler imaging in normal subjects and diabetics","volume":"37","author":"Tamaki","year":"1993","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_10","first-page":"175","article-title":"Doppler ultrasound in type I diabetes: Preliminary results","volume":"76","author":"Quintero","year":"2001","journal-title":"Arch. Soc. Esp. Oftalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1034\/j.1600-0420.2000.078004386.x","article-title":"Colour Doppler imaging of the ocular circulation in diabetic retinopathy","volume":"78","author":"MacKinnon","year":"2000","journal-title":"Acta Ophthalmol. Scand."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1038\/eye.2001.193","article-title":"Choroidal circulation in diabetic patients","volume":"15","author":"Dimitrova","year":"2001","journal-title":"Eye"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/j.1442-9071.2005.01013.x","article-title":"Effects of pars plana vitrectomy on retrobulbar haemodynamics in diabetic retinopathy","volume":"33","author":"Sullu","year":"2005","journal-title":"Clin. Experiment. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1159\/000078613","article-title":"Ocular blood flow velocity determined by color Doppler imaging in diabetic retinopathy","volume":"218","author":"Gracner","year":"2004","journal-title":"Ophthalmologica"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"675","DOI":"10.7863\/jum.1998.17.11.675","article-title":"Ocular arterial flow hemodynamics in patients with diabetes mellitus","volume":"17","author":"Arai","year":"1998","journal-title":"J. Ultrasound Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"708","DOI":"10.3109\/0886022X.2012.672266","article-title":"Evaluation of resistive index by color Doppler imaging of orbital arteries in type II diabetes mellitus patients with microalbuminuria","volume":"34","author":"Basturk","year":"2012","journal-title":"Ren. Fail."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/j.1440-1673.2007.01717.x","article-title":"Colour Doppler ultrasound evaluation of orbital vessels in diabetic retinopathy","volume":"51","author":"Baydar","year":"2007","journal-title":"Australas. Radiol."},{"key":"ref_18","unstructured":"Kannan, R. (The Hindu, 2019). India is Home to 77 Million Diabetics, Second Highest in the World, The Hindu."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"603","DOI":"10.2337\/diab.44.6.603","article-title":"Role of blood flow and impaired autoregulation in the pathogenesis of diabetic retinopathy","volume":"44","author":"Kohner","year":"1995","journal-title":"Diabetes"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/s001250051171","article-title":"Ocular blood flow and associated functional deviations in diabetic retinopathy","volume":"42","author":"Schmetterer","year":"1999","journal-title":"Diabetologia"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1542\/peds.72.4.526","article-title":"Validity of Doppler measurements of anterior cerebral artery blood flow velocity: Correlation with brain blood flow in piglets","volume":"72","author":"Hansen","year":"1983","journal-title":"Pediatrics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1148\/radiology.176.1.2112768","article-title":"Intracranial blood flow: Quantification with duplex Doppler and color Doppler flow US","volume":"176","author":"Taylor","year":"1990","journal-title":"Radiology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1136\/bjo.2003.035345","article-title":"Alteration of choroidal circulation in the foveal region in patients with type 2 diabetes","volume":"88","author":"Nagaoka","year":"2004","journal-title":"Br. J. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1038\/s41598-017-18511-7","article-title":"Choroidal Vascularity Index in Type-2 Diabetes Analyzed by Swept-Source Optical Coherence Tomography","volume":"8","author":"Kim","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.4103\/ijo.IJO_1398_19","article-title":"Evaluation of retrobulbar circulation in type 2 diabetic patients using color Doppler imaging","volume":"68","author":"Divya","year":"2020","journal-title":"Indian J. Ophthalmol."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/5\/629\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:59:35Z","timestamp":1760137175000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/5\/629"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,23]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["life12050629"],"URL":"https:\/\/doi.org\/10.3390\/life12050629","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,23]]}}}