Improvement of mild retinopathy in type 2 diabetic patients correlates with narrowing of retinal arterioles. A prospective observational study.

Abstract

PURPOSE:

Diabetic retinopathy is one of the leading causes of blindness in the Western world. The disease is characterized by morphological lesions secondary to disturbances in retinal blood flow assumed to be related to disturbances in retinal autoregulation. However, there is a need for elucidating the relation between disturbances in diameter regulation of retinal vessels and the development of diabetic retinopathy in longitudinal studies.

METHODS:

Sixty-four patients with type 2 diabetes mellitus were subjected to measurement of pressure autoregulation of retinal arterioles using the Dynamic Vessel Analyzer (DVA) and measurement of retinal thickness using OCT scanning, and after a mean of 6.8 years, 42 of the patients were re-examined. The vascular response was compared in patients in whom retinopathy had disappeared, was unchanged, or had worsened.

RESULTS:

At baseline, hemoglobin A1c (HbA1c) was significantly higher in the patients who would later experience worsening of diabetic retinopathy than in the other groups, but had been reduced at the follow-up examination. During the follow-up period, the resting diameter of retinal arterioles decreased significantly in the patients who experienced improvement in diabetic retinopathy but was unchanged in the other groups, whereas both the diameter response of retinal arterioles to isometric exercise and retinal thickness increased non-significantly with worsening of retinopathy.

CONCLUSIONS:

The development of diabetic retinopathy is related to the diameter of retinal arterioles. Future clinical intervention studies should aim at investigating the effects of normalizing arteriolar diameters in diabetic retinopathy.

• Authors: Line Pedersen, Peter Jeppesen, Søren Tang Knudsen, Per Løgstrup Poulsen, Toke Bek
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 252 Issue 10 Pg. 1561-7 (Oct 2014) ISSN: 1435-702X [Electronic] Germany
• PMID: 24687143 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• Glycated Hemoglobin A
• hemoglobin A1c protein, human

Topics

• Arterioles (pathology)
• Blood Pressure (physiology)
• Diabetes Mellitus, Type 2 (physiopathology)
• Diabetic Retinopathy (physiopathology)
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Male
• Middle Aged
• Prospective Studies
• Retinal Artery (pathology)
• Tomography, Optical Coherence
• Visual Acuity (physiology)