Macular Circulation in Patients with Diabetes Mellitus with and Without Arterial Hypertension

Overview

Journal Br J Ophthalmol

Specialty Ophthalmology

Date 2000 Nov 25

PMID 11090480

Citations 1

Authors

O Arend

M Ruffer

A Remky

Affiliations

Soon will be listed here.

Abstract

Background: Previous fluorescein angiographic studies have shown alterations in the macular microcirculation in patients with diabetes mellitus and arterial hypertension. In both diseases capillary blood velocity was reduced and capillary density decreased. These changes were more pronounced in diabetic patients. We have examined the influence of arterial hypertension in combination with diabetes mellitus.

Methods: 62 patients with diabetes mellitus and arterial hypertension (group 1) were matched with patients with diabetes mellitus but without arterial hypertension (group 2, match criteria: ETDRS stage of retinopathy). In all subjects fluorescein angiograms were performed with a scanning laser ophthalmoscope. Macular capillary blood velocity (CBV), perifoveal intercapillary area (PIA), the coefficient of variation of both parameters, the area of the foveal avascular zone (FAZ), and the arteriovenous passage time (AVP) were assessed by digital image analysis.

Results: Systolic and diastolic blood pressures were significantly increased in the patients with arterial hypertension (systolic p=0.0008; diastolic p=0.03). Neither dynamic measures (AVP: 1.64 (0.49) seconds (group 1), 1.72 (0.58) seconds (group 2); CBV: 1.98 (0.39) mm/s (group 1), 2.09 (0.43) mm/s (group 2)) nor morphological measures (PIA: 7985 (3137) microm(2) (group 1), 8338 (3376) microm(2) (group 2); FAZ: 0.319 (0.206) mm(2) (group 1), 0.363 (0.237) mm(2) (group 2)) were significantly different between the two groups of diabetic patients.

Conclusion: Arterial hypertension did not result in more severe macular capillary dropout than diabetes without hypertension. This might be explained by the fact that most of the patients were being treated with antihypertensive drugs.

Citing Articles

Circulatory parameters in the retrobulbar central retinal artery and vein of patients with diabetes and medically treated systemic hypertension.

Dimitrova G, Kato S, Fukushima H, Yamashita H Graefes Arch Clin Exp Ophthalmol. 2008; 247(1):53-8.

PMID: 18766369 DOI: 10.1007/s00417-008-0925-1.

References

Knowler W, BENNETT P, BALLINTINE E . Increased incidence of retinopathy in diabetics with elevated blood pressure. A six-year follow-up study in Pima Indians. N Engl J Med. 1980; 302(12):645-50. DOI: 10.1056/NEJM198003203021201. View

Arend O, Wolf S, Harris A, Reim M . The relationship of macular microcirculation to visual acuity in diabetic patients. Arch Ophthalmol. 1995; 113(5):610-4. DOI: 10.1001/archopht.1995.01100050078034. View

Bresnick G, Condit R, Syrjala S, Palta M, Groo A, Korth K . Abnormalities of the foveal avascular zone in diabetic retinopathy. Arch Ophthalmol. 1984; 102(9):1286-93. DOI: 10.1001/archopht.1984.01040031036019. View

Oswald B, Vilser W, Oswald H, JUTTE A, Schweitzer D, Konigsdorffer E . Measurement of flow-physiologic parameters of retinal blood circulation in type 1 and 2 diabetics before and after photocoagulation. Graefes Arch Clin Exp Ophthalmol. 1985; 223(3):154-7. DOI: 10.1007/BF02148892. View

LITTMANN H . [Determining the true size of an object on the fundus of the living eye]. Klin Monbl Augenheilkd. 1988; 192(1):66-7. DOI: 10.1055/s-2008-1050076. View

Rimmer T, Fallon T, Kohner E . Long-term follow-up of retinal blood flow in diabetes using the blue light entoptic phenomenon. Br J Ophthalmol. 1989; 73(1):1-5. PMC: 1041631. DOI: 10.1136/bjo.73.1.1. View

Janka H, Warram J, Rand L, Krolewski A . Risk factors for progression of background retinopathy in long-standing IDDM. Diabetes. 1989; 38(4):460-4. DOI: 10.2337/diab.38.4.460. View

Kohner E, Patel V, Rassam S . Role of blood flow and impaired autoregulation in the pathogenesis of diabetic retinopathy. Diabetes. 1995; 44(6):603-7. DOI: 10.2337/diab.44.6.603. View

Arend O, Harris A, Sponsel W, Remky A, Reim M, Wolf S . Macular capillary particle velocities: a blue field and scanning laser comparison. Graefes Arch Clin Exp Ophthalmol. 1995; 233(4):244-9. DOI: 10.1007/BF00183599. View

10.

Guven D, Ozdemir H, Hasanreisoglu B . Hemodynamic alterations in diabetic retinopathy. Ophthalmology. 1996; 103(8):1245-9. DOI: 10.1016/s0161-6420(96)30514-9. View

11.

Agardh C, Agardh E, Torffvit O . The association between retinopathy, nephropathy, cardiovascular disease and long-term metabolic control in type 1 diabetes mellitus: a 5 year follow-up study of 442 adult patients in routine care. Diabetes Res Clin Pract. 1997; 35(2-3):113-21. DOI: 10.1016/s0168-8227(97)01386-7. View

12.

Arend O, Remky A, Evans D, Stuber R, Harris A . Contrast sensitivity loss is coupled with capillary dropout in patients with diabetes. Invest Ophthalmol Vis Sci. 1997; 38(9):1819-24. View

13.

Guillausseau P, Massin P, Charles M, Allaguy H, Guvenli Z, Virally M . Glycaemic control and development of retinopathy in type 2 diabetes mellitus: a longitudinal study. Diabet Med. 1998; 15(2):151-5. DOI: 10.1002/(SICI)1096-9136(199802)15:2<151::AID-DIA527>3.0.CO;2-I. View

14.

Hansson L, Zanchetti A, Carruthers S, Dahlof B, Elmfeldt D, Julius S . Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet. 1998; 351(9118):1755-62. DOI: 10.1016/s0140-6736(98)04311-6. View

15.

Kutschbach P, Wolf S, Sieveking M, Ittel T, Schulte K, Reim M . Retinal capillary density in patients with arterial hypertension: 2-year follow-up. Graefes Arch Clin Exp Ophthalmol. 1998; 236(6):410-4. DOI: 10.1007/s004170050098. View

16.

Ashton N . STUDIES OF THE RETINAL CAPILLARIES IN RELATION TO DIABETIC AND OTHER RETINOPATHIES. Br J Ophthalmol. 1963; 47:521-38. PMC: 505844. DOI: 10.1136/bjo.47.9.521. View

17.

Klein R, Klein B, Moss S, Davis M, DeMets D . Is blood pressure a predictor of the incidence or progression of diabetic retinopathy?. Arch Intern Med. 1989; 149(11):2427-32. View

18.

Grunwald J, Brucker A, Petrig B, Riva C . Retinal blood flow regulation and the clinical response to panretinal photocoagulation in proliferative diabetic retinopathy. Ophthalmology. 1989; 96(10):1518-22. DOI: 10.1016/s0161-6420(89)32697-2. View

19.

Chase H, Garg S, Jackson W, Thomas M, Harris S, Marshall G . Blood pressure and retinopathy in type I diabetes. Ophthalmology. 1990; 97(2):155-9. DOI: 10.1016/s0161-6420(90)32611-8. View

20.

Norgaard K, Feldt-Rasmussen B, Deckert T . Is hypertension a major independent risk factor for retinopathy in type 1 diabetes?. Diabet Med. 1991; 8(4):334-7. DOI: 10.1111/j.1464-5491.1991.tb01606.x. View