The Blood Pressure-induced Diameter Response of Retinal Arterioles Decreases with Increasing Diabetic Maculopathy

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2006 Mar 16

PMID 16538448

Citations 25

Authors

Christian Alcaraz Frederiksen

Peter Jeppesen

Soren Tang Knudsen

Per Logstrup Poulsen

Carl Erik Mogensen

Toke Bek

Affiliations

Soon will be listed here.

Abstract

Background: The aim of the study was to compare the diameter response of retinal arterioles and retinal thickness in patients with different stages of diabetic maculopathy during an increase in the arterial blood pressure.

Methods: Four groups each consisting of 19 individuals were studied. Group A consisted of normal individuals and groups B-D consisted of type 2 diabetic patients matched for diabetes duration, age, and gender, and characterized by: Group B no retinopathy, Group C mild retinopathy, Group D maculopathy not requiring laser treatment. The diameter changes of a large retinal arteriole were measured using the Retinal Vessel Analyzer (RVA, Imedos, Germany) before, during, and after an increase in the blood pressure induced by isometric exercise. Additionally, the retinal thickness was measured using optical coherence tomography scanning.

Results: The arterioles contracted during isometric exercise in normal persons (diameter response: -0.70+/-0.48%) and in patients with no retinopathy (-1.15+/-0.44%), but dilated in patients with mild retinopathy (0.41+/-0.49%) and diabetic maculopathy (0.54+/-0.44%), p=0.01. Retinal thickness was normal in Group A (260+/-5.0 microm), Group B (257+/-4.5 microm), and Group C (253+/-4.4 microm), but was significantly (p=0.006) increased in Group D (279+/-5.3 microm).

Conclusions: The diameter response was reduced in type 2 diabetic patients with retinopathy, whereas retinal thickness was increased in patients with diabetic maculopathy. This suggests that impairment of diameter response in retinal arterioles precedes the development of diabetic macular edema.

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References

Knudsen S, Bek T, Poulsen P, Hove M, Rehling M, Mogensen C . Macular edema reflects generalized vascular hyperpermeability in type 2 diabetic patients with retinopathy. Diabetes Care. 2002; 25(12):2328-34. DOI: 10.2337/diacare.25.12.2328. View

Polak K, Dorner G, Kiss B, Polska E, Findl O, Rainer G . Evaluation of the Zeiss retinal vessel analyser. Br J Ophthalmol. 2000; 84(11):1285-90. PMC: 1723319. DOI: 10.1136/bjo.84.11.1285. View

Norris C, Barnes G, Smith E, Granger H . Autoregulation of superior mesenteric flow in fasted and fed dogs. Am J Physiol. 1979; 237(2):H174-7. DOI: 10.1152/ajpheart.1979.237.2.H174. View

Bek T . Diabetic maculopathy caused by disturbances in retinal vasomotion. A new hypothesis. Acta Ophthalmol Scand. 1999; 77(4):376-80. DOI: 10.1034/j.1600-0420.1999.770402.x. View

Fallon T, Maxwell D, Kohner E . Autoregulation of retinal blood flow in diabetic retinopathy measured by the blue-light entoptic technique. Ophthalmology. 1987; 94(11):1410-5. DOI: 10.1016/s0161-6420(87)33271-3. View

Stansberry K, Shapiro S, Hill M, McNitt P, Meyer M, Vinik A . Impaired peripheral vasomotion in diabetes. Diabetes Care. 1996; 19(7):715-21. DOI: 10.2337/diacare.19.7.715. View

Hickam J, SIEKER H . Retinal vascular reactivity in patients with diabetes mellitus and with atherosclerosis. Circulation. 1960; 22:243-6. DOI: 10.1161/01.cir.22.2.243. View

Seifertl B, Vilser W . Retinal Vessel Analyzer (RVA)--design and function. Biomed Tech (Berl). 2002; 47 Suppl 1 Pt 2:678-81. DOI: 10.1515/bmte.2002.47.s1b.678. View

Riva C, Sinclair S, Grunwald J . Autoregulation of retinal circulation in response to decrease of perfusion pressure. Invest Ophthalmol Vis Sci. 1981; 21(1 Pt 1):34-8. View

10.

Delaey C, Van de Voorde J . Regulatory mechanisms in the retinal and choroidal circulation. Ophthalmic Res. 2000; 32(6):249-56. DOI: 10.1159/000055622. View

11.

Dumskyj M, Kohner E . Retinal blood flow regulation in diabetes mellitus: impaired autoregulation and No detectable effect of autonomic neuropathy using laser doppler velocimetry, computer assisted image analysis, and isometric exercise. Microvasc Res. 1999; 57(3):353-6. DOI: 10.1006/mvre.1998.2135. View

12.

Osol G, Halpern W . Myogenic properties of cerebral blood vessels from normotensive and hypertensive rats. Am J Physiol. 1985; 249(5 Pt 2):H914-21. DOI: 10.1152/ajpheart.1985.249.5.H914. View

13.

BADEER H . Hemodynamics for medical students. Adv Physiol Educ. 2002; 25(1-4):44-52. DOI: 10.1152/advances.2001.25.1.44. View

14.

Schmetterer L, Findl O, Fasching P, FERBER W, Strenn K, Breiteneder H . Nitric oxide and ocular blood flow in patients with IDDM. Diabetes. 1997; 46(4):653-8. DOI: 10.2337/diab.46.4.653. View

15.

Sinclair S, Grunwald J, Riva C, Braunstein S, Nichols C, Schwartz S . Retinal vascular autoregulation in diabetes mellitus. Ophthalmology. 1982; 89(7):748-50. DOI: 10.1016/s0161-6420(82)34720-x. View

16.

Jeppesen P, Bek T . The occurrence and causes of registered blindness in diabetes patients in Arhus County, Denmark. Acta Ophthalmol Scand. 2004; 82(5):526-30. DOI: 10.1111/j.1600-0420.2004.00313.x. View

17.

Knudsen S, Poulsen P, Hansen K, Ebbehoj E, Bek T, Mogensen C . Pulse pressure and diurnal blood pressure variation: association with micro- and macrovascular complications in type 2 diabetes. Am J Hypertens. 2002; 15(3):244-50. DOI: 10.1016/s0895-7061(01)02281-6. View

18.

Kohner E, Hamilton A, SAUNDERS S, Sutcliffe B, Bulpitt C . The retinal blood flow in diabetes. Diabetologia. 1975; 11(1):27-33. DOI: 10.1007/BF00422814. View

19.

Stefansson E, Landers 3rd M, Wolbarsht M . Oxygenation and vasodilatation in relation to diabetic and other proliferative retinopathies. Ophthalmic Surg. 1983; 14(3):209-26. View

20.

Knudsen S, Foss C, Poulsen P, Bek T, Ledet T, Mogensen C . E-selectin-inducing activity in plasma from type 2 diabetic patients with maculopathy. Am J Physiol Endocrinol Metab. 2002; 284(1):E1-6. DOI: 10.1152/ajpendo.00198.2002. View