ABSTRACT Objective To investigate whether shear wave elastography（SWE） can be a new noninvasive diagnostic method for optic nerve stiffness in patients with diabetic retinopathy（DR）.Methods SWE was performed in 30 healthy subjects and 95 patients with diabetes mellitus（DM）.ROC curve analysis was performed.Blood glucose，blood lipid，age and body mass index（BMI） were correlated with SWE.Blood flow parameters of central retinal artery（CRA） and short posterior ciliary artery（PCAs） were observed by color Doppler ultrasonography.Results There were significant differences in SWE values of optic nerve among the groups（P＜0.001），and there were significant differences in SWE values of fat tissue in frame among the groups（P＜0.001）. There were significant differences in PSV and EDV between CRA and PCA in each group (all P < 0.001); RI of CRA and PCA would increase with the severity of DR disease progression

and RI of CRA and PCA in each group was significantly different (P < 0.001);SWE values of optic nerve and in-frame adipose tissue were positively correlated with BMI

age

triglycerides and fasting blood glucose

It was negatively correlated with high-density lipoprotein;ROC curve analysis showed that the SWE value determination of the optic nerve had a high diagnostic accuracy（AUC of 0.971，[95% CI，0.956-0.981]）；the SWE value determination of in-frame adipose tissue had a high diagnostic accuracy（AUC of 0.969，[95% CI，0.954 – 0.980]）.For the combined diagnosis of DR

the area under the curve (AUC) was 0.976 (95% confidence interval: 0.963 -0.986).Conclusion SWE value and retrobulbar vascular hemodynamics have changed in diabetic patients without retinopathy，which can provide an important basis for timely clinical intervention and control of diabetic retinopathy.The mean shear wave elasticity（Emean） and retrobulbar vascular hemodynamics in DR patients are quite different from those in normal subjects，which is of great significance for early clinical intervention and diagnosis of DR. KEYWORDS optic nerve；shear wave elastography；type 2 diabetic retinopathy；central retinal artery；short posterior ciliary artery