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. 2015 Jun 1;10(6):e0123627.
doi: 10.1371/journal.pone.0123627. eCollection 2015.

Anterior segment neovascularization in diabetic retinopathy: a masquerade

Yong Cheng  1 , Jinfeng Qu  1 , Yi Chen  1 , Mingwei Zhao  1 , Xiaoxin Li  1
Affiliations

Anterior segment neovascularization in diabetic retinopathy: a masquerade

Yong Cheng et al. PLoS One. .

Abstract

Purpose: Anterior segment neovascularization (ASNV) could be a masquerade for ocular ischemic syndrome (OIS) in diabetic patients which misleads diagnosis and treatment. The purpose of our study is to find the relationship between blood flow velocity in carotid siphon and the development of ASNV in diabetic.

Methods: We reviewed 34 eyes of 17 diabetic patients who had Transcranial Color Doppler (TCD) examination with unilateral ASNV. The circulatory parameters of both eyes of each patient were compared and analyzed. In addition, 9 patients with more than 50% stenosis of extracranial internal carotid artery (ICA) and low velocity flow through TCD had been treated by carotid revascularization surgery.

Results: The maximal velocity in systole (Vmax) of carotid siphon (SCA) was lower in the eyes with ASNV than in the eyes without ASNV (P<0.05). ASNV of all the 9 patients regressed totally and BCVA improved significantly (P<0.05). Stenosis of ICA and arm-retina time (ART) decreased significantly (P<0.01) and SCA and ophthalmic artery (OA) increased significantly (P<0.01).

Conclusions: Our study showed ASNV could be a masquerade for OIS in patients with diabetic retinopathy. The decreased blood flow velocity in carotid siphon is related to the development of ASNV. Circulatory parameters screening of SCA by TCD is important to help us to evaluate the blood flow in SCA, the possibility of development of ASNV, and the prognosis of the patient. Interference such as carotid endarterectomy (CEA) or carotid artery stenting (CAS) can be performed if necessary to improve the blood flow in SCA and make ASNV regression.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. ASNV disappeared with Vmax in right SCA and OA improved after CEA in patient 1.
A, INV can be seen at the pupil margin from 9 to 11 o’clock in the right eye before CEA. B, INV in the right eye disappeared at 10 days after CEA. C, TCD examination showed lower Vmax in right SCA and OA comparing to the left side before CEA in the right ICA. D, TCD examination showed improved Vmax in right SCA and OA comparing to the left side at 10 days after CEA in the right ICA.
See this image and copyright information in PMC

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