Retinal blood flow is increased in type 1 diabetes mellitus patients with advanced stages of retinopathy

BMC Endocrine Disorders

Research Article

Frank D. Verbraak¹  Peter J. Ringens²  Hoang-Ton Nguyen³  Bettine C. P. Polak³  Annette C. Moll³  Eelco van Duinkerken⁴  Michaela Diamant⁵ 

[1] Department of Ophthalmology, Academic Medical Center, Amsterdam, The Netherlands;Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands;Department of Ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands;Department of Ophthalmology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;Diabetes Center/Department of Internal Medicine and Department of Medical Psychology/Psychosocial Diabetology Section, VU University Medical Center, Amsterdam, The Netherlands;Department of Psychology, Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil;Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands;

关键词: Diabetes;    Diabetic retinopathy;    Hemodynamics;    Laser-doppler flowmetry;   

DOI  :  10.1186/s12902-016-0105-y

 received in 2015-09-01, accepted in 2016-05-12,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundDiabetic retinopathy (DRP) is a common microvascular complication seen in patients with type 1 diabetes mellitus (T1DM). The effects of T1DM and concomitant (proliferative) DRP on retinal blood flow are currently unclear. Therefore, we measured retinal vascular blood flow in T1DM patients with and without DRP and non-diabetic controls. We further assessed the acute effects of panretinal photocoagulation on retinal microvascular bloodflow in eight patients with diabetes.MethodsThirty-three T1DM patients with proliferative DRP, previously treated with panretinal photocoagulation (pDRP), 11 T1DM patients with untreated non-proliferative retinopathy (npDRP) and 32 T1DM patients without DRP (nDRP) were compared with 44 non-diabetic gender-matched controls. Using scanning laser Doppler flowmetry (HRF, Heidelberg) blood flow in the retinal microvasculature was measured temporal and nasal of the optic disc and averaged into one flow value per eye. The right eye was used as a default for further analyses. Eight patients with novel proliferative retinopathy (4 T1DM and 4 with type 2 diabetes) were measured before and several months after photocoagulation. Between-group differences in retinal blood flow were assessed using ANOVA corrected for multiple comparisons (Bonferroni).ResultsRetinal blood flow was higher in the treated pDRP compared with the nDRP group and controls (all PBonferroni < 0.01). Furthermore, there was a positive linear trend for blood flow with lowest blood flow in the control group and highest in the pDRP group (P-for-trend < 0.01). In the eight patients with novel proliferative retinopathy, blood flow did not significantly change before and after panretinal photocoagulation (P > 0.05). Using regression analysis, no variables were found as predictors of retinal blood flow.ConclusionsIn comparison with controls and nDRP patients, retinal blood flow significantly increased in the pDRP group, which previously underwent photocoagulation treatment, but not in the npDRP patients. These changes may be a consequence of a failing vascular autoregulation in advanced diabetic retinopathy.

【 授权许可】

CC BY   
© Nguyen et al. 2016