nach oben

Current Diabetes Reports

Erschienen in:

01.10.2017 | Microvascular Complications—Retinopathy (JK Sun and PS Silva, Section Editors)

Diameter Changes of Retinal Vessels in Diabetic Retinopathy

verfasst von: Toke Bek

Erschienen in: Current Diabetes Reports | Ausgabe 10/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

The diameter of retinal vessels is an important source of information about retinal blood flow and metabolism. The purpose of the present study is to review how diameter changes of retinal vessels contribute to the development of diabetic retinopathy and may be a marker of the prognosis of the disease.

Recent Findings

The early stages of diabetic retinopathy are accompanied with dilatation of the diameter of retinal vessels and reduced autoregulation. Diabetic retinopathy also shows regional differences in the macular area and the retinal periphery and accompanying differences in vascular reactivity in these areas. These differences may potentially become an important source of insight into the pathophysiology of the disease in the future.

Summary

Diabetic retinopathy is accompanied with changes in the diameter regulation of retinal vessels. The potential of newly developed techniques for assessing retinal blood flow and metabolism, such as Doppler techniques, adaptive optics, and retinal oximetry, is promising and may potentially contribute to significant advances in our understanding of diabetic retinopathy which remains a major cause of visual impairment.

Pournaras CJ, Rungger-Brändle E, Riva CE, Hadarson SH, Stefansson E. Regulation of retinal blood flow in health and disease. Prog Retin Eye Res. 2008;27/3:284–330.CrossRef

Michaelson IC. Retinal circulation in man and animals. Springfield: Thomas; 1954. p. 1–146.

Rassam SM, Patel V, Brinchmann-Hansen O, Engvold O, Kohner EM. Accurate vessel width measurement from fundus photographs: a new concept. Br J Ophthalmol. 1994;78/1:24–9.CrossRef

Garhofer G, Bek T, Boehm AG, Gherghel D, Grunwald J, Jeppesen P, et al. Use of the retinal vessel analyzer in ocular blood flow research. Acta Ophthalmol. 2010;88/7:717–22.CrossRef

Tilma KK, Bek T. Topical treatment for 1 week with latanoprost but not diclofenac reduces the diameter of dilated retinal arterioles in patients with type 1 diabetes mellitus and mild retinopathy. Acta Ophthalmology. 2012;90/8:750–5.CrossRef

Lopez Torres LT, Türksever C, Schötzau A, Orgül S, Todorova MG. Peripapillary retinal vessel diameter correlates with mfERG alterations in retinitis pigmentosa. Acta Ophthalmol. 2015;7:e527–33.CrossRef

Laties AM. Central retinal artery innervation. Absence of adrenergic innervation to the intraocular branches. Arch. Ophthalmology. 1967;77:405–9.

Bek T. Regional morphology and pathophysiology of retinal vascular disease. Prog Retin Eye Res. 2013;36:247–59.CrossRefPubMed

Pemp B, Schmetterer L. Ocular blood flow in diabetes and age-related macular degeneration. Can J Ophthalmol. 2008;43/3:295–301.CrossRef

10.

Simonsen SE. The value of the oscillatory potential in selecting juvenile diabetics at risk of developing proliferative retinopathy. Acta Ophthalmol. 1980;58/6:865–78.

11.

Bek T. Immunohistochemical characterization of retinal glial cell changes in areas of vascular occlusion secondary to diabetic retinopathy. Acta Ophthalmol. 1997;75/4:388–92.

12.

Bek T. Glial cell involvement in vascular occlusion of diabetic retinopathy. Acta Ophthalmol. 1997;75/3:239–43.

13.

Misfeldt M, Pedersen SM, Bek T. Perivascular cells with pericyte characteristics are involved in ATP and PGE2 induced relaxation of porcine retinal arterioles in vitro. Invest Ophthalmol Vis Sci. 2013;54/5:3258–64.CrossRef

14.

Kudryavtseva O, Aalkjaer C, Bek T. Prostaglandin induced changes in the tone of porcine retinal arterioles in vitro involve other factors than calcium activity in perivascular cells. Exp Eye Res. 2015;138:96–103.CrossRefPubMed

15.

Schocket LS, Grunwald JE, Tsang AF, DuPont J. The effect of pregnancy on retinal hemodynamics in diabetic versus nondiabetic mothers. Am J Ophthalmol. 1999;128/4:477–84.CrossRef

16.

Chen HC, Newsom RS, Patel V, Cassar J, Mather H, Kohner EM. Retinal blood flow changes during pregnancy in women with diabetes. Invest Ophthalmol Vis Sci. 1994;35/8:3199–208.

17.

Larsen M, Colmorn LB, Bønnelycke M, Kaaja R, Immonen I, Sander B, et al. Retinal artery and vein diameters during pregnancy in diabetic women. Invest Ophthalmol Vis Sci. 2005;46/2:709–13.CrossRef

18.

Lauszus FF, Klebe JG, Bek T, Flyvbjerg A. Increased serum IGF-I during pregnancy is associated with progressino of diabetic retinopathy. Diabetes. 2003;52/3:852–6.CrossRef

19.

Broe R, Rasmussen ML, Frydkjaer-Olsen U, Olsen BS, Mortensen HB, Hodgson L, et al. Retinal vessel calibers predict long-term microvascular complications in type 1 diabetes. The Dansh Cohort of Pediatic Diabetes 1987 (DCPD1987). Diabetes. 2014;63/11:3906–14.CrossRef

20.

Pedersen L, Jeppesen P, Knudsen ST, Poulsen PL, Bek T. Improvement of mild retinopathy in type 2 diabetic patients correlates with narrowing of retinal arterioles. A prospective observational study. Graefes Arch Clin Exp Ophthalmol. 2014;252/10:1561–7.CrossRef

21.

Frydkjaer-Olsen U, Soegaard Hansen R, Simó R, Cunha-Vaz J, Peto T, Grauslund J. Correlation between retinal vessel caliber and neurodegeneration in patients with type 2 diabetes mellitus in the European Consortium for the Early Treatment of Diabetic Retinopathy (EUROCONDOR). Ophthalmic Res. 2016;56/1:10–6.CrossRef

22.

Klein R, Myers CE, Lee KE, Gangnon R, Klein BE. Changes in retinal vessel diameter and incidence and progression of diabetic retinopathy. Arch Ophthalmol. 2012;130/6:749–55.

23.

Petersen L, Bek T. The diameter response of retinal arterioles in diabetic maculopathy is reduced during hypoxia and is unaffected by the inhibition of cyclo-oxygenase and nitric oxide synthesis. Graefes Arch Clin Exp Ophthalmol. 2016;254/12:2339–46.CrossRef

24.

Petersen L, Bek T. Preserved pressure autoregulation but disturbed cyclo-oxygenase and nitric oxide effects on retinal arterioles during acute hypoxia in diabetic patients without retinopathy. Ophthalmologica. 2016;235/2:114–20.CrossRef

25.

Kristinsson JK, Gottfredsdóttir MS, Stefánsson E. Retinal vessel dilatation and elongation precedes diabetic macular oedema. Br J Ophthalmol. 1997;81/4:274–8.CrossRef

26.

Pemp B, Cherecheanu AP, Garhofer G, Schmetterer L. Calculation of central retinal artery diameters from non-invasive ocular haemodynamic measurements in type 1 diabetes patients. Acta Ophthalmol. 2013;91/5:e348–52.CrossRef

27.

Godfredsdóttir MS, Stefánsson E, Jónasson F, Gíslason I. Retinal vasoconstriction after laser treatment for diabetic macular edema. Am J Ophthalmol. 1993;115/1:64–7.CrossRef

28.

Jeppesen P, Sanye-Hajari J, Bek T. Increased blood pressure induces a diameter response of retinal arterioles that increases with decreasing arteriolar diameter. Invest Ophthalmol Vis Sci. 2007;48/1:328–31.CrossRef

29.

Kohner EM, Patel V, Rassam SM. Role of blood flow and impaired autoregulation in the pathogenesis of diabetic retinopathy. Diabetes. 1995;44/6:603–7.CrossRef

30.

Jeppesen P, Gregersen PA, Bek T. The age-dependent decrease in the myogenic response of retinal arterioles as studied with the retinal vessel analyzer. Graefes Arch Clin Exp Ophthalmol. 2004;242/11:914–9.CrossRef

31.

Garhöfer G, Zawinka C, Resch H, Kothy P, Schmetterer L, Dorner GT. Reduced response of retinal vessel diameters to flicker stimulation in patients with diabetes. Br J Ophthalmol. 2004;88/7:887–91.CrossRef

32.

Frederiksen CA, Jeppesen P, Knudsen ST, Poulsen PL, Mogensen CE, Bek T. The blood pressure-induced diameter response of retinal arterioles decreases with increasing diabetic maculopathy. Graefes Arch Clin Exp Ophthalmol. 2006;244/10:1255–61.CrossRef

33.

Bek T, Helgesen A. The regional distribution of diabetic retinopathy lesions may predict risk factors for the progression of the disease. Acta Ophthalmol. 2001;79:501–5.CrossRef

34.

Bek T, Hajari J, Jeppesen P. Interaction between flicker-induced vasodilatation and pressure autoregulation in early retinopathy of type 2 diabetes. Graefes Arch Clin Exp Ophthalmol. 2008;246/5:763–9.CrossRef

35.

Nguyen TT, Kawasaki R, Kreis AJ, Wang JJ, Shaw J, Vilser W, et al. Correlation of light-flicker-induced retinal vasodilation and retinal vascular caliber measurements in diabetes. Invest Ophthalmol Vis Sci. 2009;50/12:5609–13.CrossRef

36.

Mandecka A, Dawczynski J, Vilser W, Blum M, Müller N, Kloos C, et al. Diabetes Res Clin Pract. 2009;86/1:51–5.CrossRef

37.

Lecleire-Collet A, Audo I, Aout M, Girmens JF, Sofroni R, Erginay A, et al. Evaluation of retinal function and flicker light-induced retinal vascular response in normotensive patients with diabetes without retinopathy. Invest Ophthalmol Vis Sci. 2011;52/6:2861–7.CrossRef

38.

Hammer M, Heller T, Jentsch S, Dawczynski J, Schweitzer D, Peters S, et al. Invest Ophthalmol Vis Sci. 2012;53/7:4063–8.CrossRef

39.

Felder AE, Wanek J, Blair NP, Joslin CE, Brewer KC, Chau FY, et al. The effects of diabetic retinopathy stage and light flicker on inner retinal oxygen extraction fraction. Invest Ophthalmol Vis Sci. 2016;57/13:5586–92.CrossRef

40.

Mehlsen J, Jeppesen P, Erlandsen M, Poulsen PL, Bek T. Lack of effect of short-term treatment with amlodipine and lisinopril on retinal autoregulation in normotensive patients with type 1 diabetes and mild diabetic retinopathy. Acta Ophthalmol. 2011;89/8:764–8.CrossRef

41.

Pemp B, Garhofer G, Weigert G, Karl K, Resch H, Wolzt M, et al. Reduced retinal vessel response to flicker stimulation but not to exogenous nitric oxide in type 1 diabetes. Invest Ophthalmol Vis Sci. 2009;50/9:4029–32.CrossRef

42.

Kaya MY, Petersen L, Bek T. Lack of effect of nitroglycerin on the diameter response of larger retinal arterioles in normal persons during hypoxia. Graefes Arch Clin Exp Ophthalmol. 2016;254/2:277–83.CrossRef

43.

Mishra A, Newman EA. Inhibition of inducible nitric oxide synthase reverses the loss of functional hyperemia in diabetic retinopathy. Glia. 2010;58/16:1996–2004.CrossRef

44.

Dorner GT, Garhofer G, Kiss B, Polska E, Polak K, Riva CE, et al. Nitric oxide regulates retinal vascular tone in humans. Am J Physiol Heart Circ Physiol. 2003;285/2:H631–6.CrossRef

45.

Bek T. Diabetic maculopathy caused by disturbances in retinal vasomotion. A new hypothesis. Acta Ophthalmol. 1999;77/4:376–80.CrossRef

46.

Bek T. Lack of correlation between short-term dynamics of diabetic retinopathy lesions and the arterial blood pressure. Graefes Arch Clin Exp Ophthalmol. 2011;249/2:267–71.CrossRef

47.

Bek T, Jeppesen P, Kanters JK. Spontaneous high frequency diameter oscillations of larger retinal arterioles are reduced in type 2 diabetes mellitus. Invest Ophthalmol Vis Sci. 2013;54/1:636–40.CrossRef

48.

Taylor E, Dobree JH. Proliferative diabetic retinopathy. Site and size of initial lesions. Br J Ophthalmol. 1970;54/1:11–8.CrossRef

49.

Lahrmann C, Bek T. Foveal haemorrhages in diabetic retinopathy. Clinical characteristics and visual outcome. Acta Ophthalmol. 2000;78/2:169–72.CrossRef

50.

Hove MN, Kristensen JK, Lauritzen T, Bek T. Quantitative analysis of retinopathy in type 2 diabetes. Identification of prognostic parameters for developing visual loss secondary to diabetic maculopathy. Acta Ophthalmol. 2004;82/6:679–85.CrossRef

51.

Skov Jensen P, Jeppesen P, Bek T. Differential diameter responses in macular and peripheral retinal arterioles may contribute to the regional distribution of diabetic retinopathy lesions. Graefes Arch Clin Exp Ophthalmol. 2011;249/3:407–12.CrossRef

52.

Jørgensen CM, Bek T. Lack of differences in the regional variation of oxygen saturation in larger retinal vessels in diabetic maculopathy and proliferative diabetic retinopathy. Br J Ophthalmol. 2016; doi:10.1136/bjophthalmol-2016-308894.

53.

Tayyari F, Khuu LA, Flanagan JG, Singer S, Brent MH, Hudson C. Retinal blood flow and retinal blood oxygen saturation in mild to moderate diabetic retinopathy. Invest Ophthalmol Vis Sci. 2015;56/11:6796–800.CrossRef

54.

• Luft N, Wozniak PA, Aschinger GC, Fondi K, Bata AM, Werkmeister RM, et al. Measurements of retinal perfusion using laser speckle flowgraphy and Doppler optical coherence tomography. Invest Ophthalmol Vis Sci. 2016;57/16:5417–25. The study shows how a combination of the linear flow and vessel diameters can be used to quantify blood flow in single retinal vessels. CrossRef

55.

Bek T. Fine structure in diabetic retinopathy lesions as observed by adaptive optics imaging. A qualitative study. Acta Ophthalmol. 2014;92/8:753–8.CrossRef

56.

Arichika S, Uji A, Murakami T, Suzuma K, Gotoh N, Yoshimura N. Correlation of retinal arterial wall thickness with atherosclerosis predictors in type 2 diabetes without clinical retinopathy. Br J Ophthalmol. 2017;101/1:69–74.CrossRef

57.

• Jørgensen CM, Hardarson SH, Bek T. The oxygen saturation in retinal vessels from diabetic patients depends on the severity and type of vision threatening retinopathy. Acta Ophthalmol. 2014;92/1:34–9. The study shows that the oxygen saturation in retinal venules increases with increasing severity of diabetic retinopathy. CrossRef

Titel: Diameter Changes of Retinal Vessels in Diabetic Retinopathy
verfasst von: Toke Bek
Publikationsdatum: 01.10.2017
Verlag: Springer US
Erschienen in: Current Diabetes Reports / Ausgabe 10/2017
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-017-0909-9

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 10/2017

Screening Intervals for Diabetic Retinopathy and Implications for Care

Heterogeneity in the Beta-Cell Population: a Guided Search Into Its Significance in Pancreas and in Implants

Tolerogenic Nanoparticles to Treat Islet Autoimmunity

Deciphering the Pathogenesis of Human Type 1 Diabetes (T1D) by Interrogating T Cells from the “Scene of the Crime”

Diabetic Eye Screening: Knowledge and Perspectives from Providers and Patients