Hemodynamic Changes in the Ophthalmic Artery and Their Correlation with Serum Cytokines in Pediatric Diabetic Retinopathy

Abstract

Background: Diabetic retinopathy (DR) is a common microvascular complication in children with type 2 diabetes mellitus (T2DM), whose pathogenesis involves microcirculatory dysfunction and chronic inflammatory responses. Objectives: This cross-sectional study aimed to investigate the changes in ocular artery hemodynamic parameters in children with T2DM and analyze their correlation with serum inflammatory factor levels. Methods: A total of 188 children with T2DM were divided into a no diabetic retinopathy (no-DR) group, a nonproliferative diabetic retinopathy (NPDR) group, and a proliferative diabetic retinopathy (PDR) group, with a healthy control group also included. Ocular artery hemodynamic parameters (peak systolic velocity (PSV), end-diastolic velocity (EDV), Resistance Index (RI), Pulsatility Index (PI)) and serum levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and transforming growth factor-β (TGF-β) were measured in all groups. Results: Compared with the control group, the no-DR group, NPDR group, and PDR group showed a progressive decrease in PSV and EDV, and a progressive increase in RI; levels of VEGF, TNF-α, and IL-6 showed a progressive increase, while TGF-β levels showed a progressive decrease (all P < 0.001). PSV and EDV were significantly negatively correlated with pro-inflammatory factors, while RI was significantly positively correlated with pro-inflammatory factors (all P < 0.01). Conclusions: Children with T2DM exhibit significant ocular artery hemodynamic abnormalities (including decreased EDV) and alterations in inflammatory factor levels, which are closely interrelated. Combined assessment of these indicators may aid in the early identification of children at high risk for DR and provide new targets for clinical intervention.