Role of ischemia in the pathogenesis of diabetic vitreopapillary traction syndrome

Babaeva D.B., Shishkin M.M., Fayzrakhmanov R.R.

Objective: to evaluate the role of ischemia in the pathogenesis of diabetic vitreopapillary traction syndrome.

Material and methods: The analysis is based on a sample of 30 patients with diabetic vitreopapillary traction syndrome. The study included a standard ophthalmological examination, color doppler mapping, fluorescent angiography. All patients underwent three-port vitrectomy to eliminate traction syndrome.

Results: The results of the obtained data indicated that patients with diabetic vitreopapillary traction syndrome had significant changes in the hemodynamics of the eye compared to the normal parameters. А significant difference in a blood flow parameters in the posterior short ciliary arteries system was recorded in eyes with vitreopapillary traction syndrome compaired to paired eyes.

Conclusion: The results of the studies indicate that patients with diabetic vitreopapillary traction syndrome have significant changes in regional hemodynamics: a decrease in blood flow velocity in the central retinal artery, posterior short ciliary arteries and an increase in peripheral vascular resistance, which indicates ischemia of the optic nerve head and may also be one of the reasons for the development of vitreopapillary traction.

1. Kiseleva T.N. Tsvetovoe dopplerovskoe kartirovanie v oftal’mologii // Vestnik oftal’mologii 2001. № 6. S. 50-52. (In Russ.)

2. Fayzrakhmanov R.R., Pavlovsky O.A., Lukinykh M.A., Egorova N.S. Surgical treatment of diabetic macular edema. Russian Ophthalmological Journal. 2024;17(3): 139-144. (In Russ.)

3. Babaeva D.B., Shishkin M.M. Otsenka krovosnabzheniya u patsientov s diabeticheskim vitreopapillyarnym traktsionnym sindromom // XI Rossiiskii Obshchenatsional’nyi Oftal’mologicheskii Forum: Sbornik nauchnykh trudov– 2018. – T.2– S.517-521 (In Russ.)

4. Goebel W. [et al.] Color Doppler imaging: a new technique to assess orbital blood flow in patients with diabetic retinopathy. Invest. Ophthalmol. Vis.Sci. – 1995. – Vol. 36, №5. – Р. 864–870.

5. Phacoemulsification of primary cataract by the second stage after vitreoretinal surgery of proliferative diabetic retinopathy patients Karina I. Konovalova*, Mihail M. Shishkin, Rinat R. Fayzrakhmanov N.I. Pirogov Russian National Medical Surgical Center, Moscow, Russia (In Russ.)

6. Gracner T. Ocular blood flow velocity determined by color Doppler imaging in diabetic retinopathy. Ophthalmologica 2004;218:237–242

7. Babayeva DB, Shishkin MM, Fayzrakhmanov RR, Konovalova KI. Vitreopapillary traction syndrome in patients with proliferative diabetic retinopathy. Russian Annals of Ophthalmology. 2021;137(6):38 44. (In Russ.)

8. Kroll P., Wiegand W., Schmidt J.C.: Vitreopapillary traction in proliferative diabetic vitreoretinopathy // Br. J. Ophthalmol. 1999; 83: P. 261–264.

9. Hayreh S.S., Ocular Vascular Occlusive Disorders, Springer International Publishing Switzerland. – 2015. – Р. 103-106).

10. Hayreh S.S. Blood supply and vascular disorders of the optic nerve // An. Inst. Barraquer. 1963; № 4: 7–109).

11. Valli A. [et al.] Color Doppler imaging to evaluate the action of a drug in ocular pathology / // Ophthalmologica. – 1995. – Vol.209. – P.117-121.

12. lsayama Y., Hiramatsu K., Asakwa S. Et al/ Posterior ischemic optic neuropathy. 1. Blood supply of the optic nerve // Ophthalmologica (Basel). – 1983. – Vol. 186. – P. 194–203.

13. Sofroniew M.V. Astrocytes: biology and pathology /Sofroniew M.V., Vinters H.V. //Acta Neuropathol., 2010. – V. 119. P.7–35.