Evaluation of Diabetic Retinopathy in Patients With Diabetes Mellitus Using 2D-Shear Wave Elastography (SWE), Ultra-Microangiography (UMA), and Doppler Imaging.

To investigate the applicability of optic nerve shear wave elastography (SWE) and ultra-microangiography (UMA) in the diagnosis of diabetic retinopathy (DR) in diabetic patients and to demonstrate the effect of diabetes on the vasculopathy of the central retinal-ophthalmic artery using Doppler. Our study was conducted prospectively between July and August 2025 and consisted of 88 diabetic patients and 43 healthy controls. After biochemical parameters were examined in the endocrinology clinic, fundus examination findings were recorded in the ophthalmology clinic. At the ultrasound clinic, after the patient closed their right eye and was evaluated on a gray scale, Doppler data of the central retinal-ophthalmic artery were recorded. Subsequently, the optic nerve and retinal vascular structures were evaluated using 2D-SWE and UMA modalities. In DR patients, 2D-SWE values of the optic nerve were significantly higher compared to the diabetes mellitus non-retinopathy (DM-NR) and control groups (p < 0.05). Diabetic patients (DR+DM-NR) showed a significant increase in retinal artery and ophthalmic artery RI, HbA1C, and fasting and post-prandial glucose values compared to the control group (p < 0.05). Diabetic patients (DR+DM-NR) showed a significant decrease in UMA-color pixel percentage (CPP) values compared to the control group (p < 0.05). Our study demonstrated that increased SWE values in DR patients can be used in addition to fundoscopy findings for the diagnosis of retinopathy. Additionally, our study demonstrated the effects of diabetes-related vasculopathy in the central retinal-ophthalmic arteries and microvascular structures in the retrobulbar fat tissue using Doppler and UMA.