Color Doppler ultrasound study: assessing orbital hemodynamics and vascular changes in mucosal lichen planus

Lichen planus (LP) is a chronic inflammatory condition that can have systemic implications, including effects on vascular health. This exploratory study aimed to evaluate orbital hemodynamics and vascular changes in patients with mucosal LP using color Doppler ultrasound (CDU).

This retrospective case‑control study enrolled 25 mucosal LP patients along with 30 age‑ and gender‑matched subjects. CDU was used to evaluate the resistive index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end‑diastolic velocity (EDV) in the ophthalmic artery (OA), short posterior ciliary arteries (PCAs), and central retinal artery (CRA). The severity of mucosal LP was assessed with the White Erosive Atrophic Modified Scoring System (WEA‑MOD). All patients underwent complete ophthalmic examination as well as determination of choroidal thickness (CT) using a high‑speed, high‑resolution spectral‑domain optical coherence tomography (SD‑OCT) device. Doppler ultrasonographic measurements revealed significant differences in multiple hemodynamic parameters between LP patients and controls associated with the PCA (p < 0.05). Notable differences were observed in parameters such as OA‑RI, OA‑PI, CRA‑EDV, CRA‑RI, CRA‑PI, and PCA‑PSV (all p < 0.05), with significant variations correlating with different LP severity scores (p = 0.021). Although CT measurements did not differ significantly between the two groups overall, notable variations were observed when assessing CT across different levels of LP severity. CT measurements were significantly lower in the LP group, and significant variations were observed when assessing CT across different levels of LP severity (p < 0.001). These associational findings suggest that mucosal LP severity is associated with altered orbital hemodynamics. These findings raise the possibility that color Doppler ultrasound might serve as a non‑invasive tool to identify patients at higher risk of subclinical ocular vascular changes. Prospective studies are needed to determine whether these hemodynamic alterations predict future ocular complications and whether they warrant monitoring or adjunctive vascular‑protective strategies. Due to the retrospective and cross‑sectional design, causality cannot be inferred. This hypothesis‑generating study underscores the need for larger, longitudinal investigations.