Skip to main content
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 10/2006

01.10.2006 | Clinical Investigation

The blood pressure-induced diameter response of retinal arterioles decreases with increasing diabetic maculopathy

verfasst von: Christian Alcaraz Frederiksen, Peter Jeppesen, Søren Tang Knudsen, Per Løgstrup Poulsen, Carl Erik Mogensen, Toke Bek

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 10/2006

Einloggen, um Zugang zu erhalten

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 μm), Group B (257±4.5 μm), and Group C (253±4.4 μm), but was significantly (p=0.006) increased in Group D (279±5.3 μm).

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.
Literatur
1.
Zurück zum Zitat Badeer HS (2001) Hemodynamics for medical students. Adv Physiol Educ 25:44–52PubMed Badeer HS (2001) Hemodynamics for medical students. Adv Physiol Educ 25:44–52PubMed
2.
Zurück zum Zitat Bek T (1999) Diabetic maculopathy caused by disturbances in retinal vasomotion. A new hypothesis. Acta Ophthalmol Scand 77:376–380PubMedCrossRef Bek T (1999) Diabetic maculopathy caused by disturbances in retinal vasomotion. A new hypothesis. Acta Ophthalmol Scand 77:376–380PubMedCrossRef
3.
Zurück zum Zitat Delaey C, Van DV (2000) Regulatory mechanisms in the retinal and choroidal circulation. Ophthalmic Res 32:249–256PubMedCrossRef Delaey C, Van DV (2000) Regulatory mechanisms in the retinal and choroidal circulation. Ophthalmic Res 32:249–256PubMedCrossRef
4.
Zurück zum Zitat Dumskyj MJ, Kohner EM (1999) 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 57:353–356PubMedCrossRef Dumskyj MJ, Kohner EM (1999) 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 57:353–356PubMedCrossRef
5.
Zurück zum Zitat Fallon TJ, Maxwell DL, Kohner EM (1987) Autoregulation of retinal blood flow in diabetic retinopathy measured by the blue-light entoptic technique. Ophthalmology 94:1410–1415PubMed Fallon TJ, Maxwell DL, Kohner EM (1987) Autoregulation of retinal blood flow in diabetic retinopathy measured by the blue-light entoptic technique. Ophthalmology 94:1410–1415PubMed
6.
Zurück zum Zitat Fong DS, Aiello LP, Ferris FL III, Klein R (2004) Diabetic retinopathy. Diabetes Care 27:2540–2553PubMedCrossRef Fong DS, Aiello LP, Ferris FL III, Klein R (2004) Diabetic retinopathy. Diabetes Care 27:2540–2553PubMedCrossRef
7.
Zurück zum Zitat Grunwald JE, DuPont J, Riva CE (1996) Retinal haemodynamics in patients with early diabetes mellitus. Br J Ophthalmol 80:327–331PubMedCrossRef Grunwald JE, DuPont J, Riva CE (1996) Retinal haemodynamics in patients with early diabetes mellitus. Br J Ophthalmol 80:327–331PubMedCrossRef
8.
Zurück zum Zitat Hickam JB, Sieker HO (1960) Retinal vascular reactivity in patients with diabetes mellitus and with atherosclerosis. Circulation 22:243–246PubMed Hickam JB, Sieker HO (1960) Retinal vascular reactivity in patients with diabetes mellitus and with atherosclerosis. Circulation 22:243–246PubMed
9.
Zurück zum Zitat Jeppesen P, Bek T (2004) The occurrence and causes of registered blindness in diabetes patients in Arhus County, Denmark. Acta Ophthalmol Scand 82:526–530PubMedCrossRef Jeppesen P, Bek T (2004) The occurrence and causes of registered blindness in diabetes patients in Arhus County, Denmark. Acta Ophthalmol Scand 82:526–530PubMedCrossRef
10.
Zurück zum Zitat Jeppesen P, Gregersen PA, Bek T (2004) The age-dependent decrease in the myogenic response of retinal arterioles as studied with the Retinal Vessel Analyzer. Graefes Arch Clin Exp Ophthalmol 242:914–919PubMedCrossRef Jeppesen P, Gregersen PA, Bek T (2004) The age-dependent decrease in the myogenic response of retinal arterioles as studied with the Retinal Vessel Analyzer. Graefes Arch Clin Exp Ophthalmol 242:914–919PubMedCrossRef
11.
Zurück zum Zitat Knudsen ST, Bek T, Poulsen PL, Hove MN, Rehling M, Mogensen CE (2002) Macular edema reflects generalized vascular hyperpermeability in type 2 diabetic patients with retinopathy. Diabetes Care 25:2328–2334PubMedCrossRef Knudsen ST, Bek T, Poulsen PL, Hove MN, Rehling M, Mogensen CE (2002) Macular edema reflects generalized vascular hyperpermeability in type 2 diabetic patients with retinopathy. Diabetes Care 25:2328–2334PubMedCrossRef
12.
Zurück zum Zitat Knudsen ST, Foss CH, Poulsen PL, Bek T, Ledet T, Mogensen CE et al (2003) E-selectin-inducing activity in plasma from type 2 diabetic patients with maculopathy. Am J Physiol Endocrinol Metab 284:E1–E6PubMed Knudsen ST, Foss CH, Poulsen PL, Bek T, Ledet T, Mogensen CE et al (2003) E-selectin-inducing activity in plasma from type 2 diabetic patients with maculopathy. Am J Physiol Endocrinol Metab 284:E1–E6PubMed
13.
Zurück zum Zitat Knudsen ST, Poulsen PL, Hansen KW, Ebbehoj E, Bek T, Mogensen CE (2002) Pulse pressure and diurnal blood pressure variation: association with micro- and macrovascular complications in type 2 diabetes. Am J Hypertens 15:244–250PubMedCrossRef Knudsen ST, Poulsen PL, Hansen KW, Ebbehoj E, Bek T, Mogensen CE (2002) Pulse pressure and diurnal blood pressure variation: association with micro- and macrovascular complications in type 2 diabetes. Am J Hypertens 15:244–250PubMedCrossRef
14.
Zurück zum Zitat Kohner EM, Hamilton AM, Saunders SJ, Sutcliffe BA, Bulpitt CJ (1975) The retinal blood flow in diabetes. Diabetologia 11:27–33PubMedCrossRef Kohner EM, Hamilton AM, Saunders SJ, Sutcliffe BA, Bulpitt CJ (1975) The retinal blood flow in diabetes. Diabetologia 11:27–33PubMedCrossRef
15.
Zurück zum Zitat Kristinsson JK, Gottfredsdottir MS, Stefansson E (1997) Retinal vessel dilatation and elongation precedes diabetic macular oedema. Br J Ophthalmol 81:274–278PubMedCrossRef Kristinsson JK, Gottfredsdottir MS, Stefansson E (1997) Retinal vessel dilatation and elongation precedes diabetic macular oedema. Br J Ophthalmol 81:274–278PubMedCrossRef
16.
Zurück zum Zitat Norris CP, Barnes GE, Smith EE, Granger HJ (1979) Autoregulation of superior mesenteric flow in fasted and fed dogs. Am J Physiol 237:H174–H177PubMed Norris CP, Barnes GE, Smith EE, Granger HJ (1979) Autoregulation of superior mesenteric flow in fasted and fed dogs. Am J Physiol 237:H174–H177PubMed
17.
Zurück zum Zitat Osol G, Halpern W (1985) Myogenic properties of cerebral blood vessels from normotensive and hypertensive rats. Am J Physiol 249:H914–H921PubMed Osol G, Halpern W (1985) Myogenic properties of cerebral blood vessels from normotensive and hypertensive rats. Am J Physiol 249:H914–H921PubMed
18.
Zurück zum Zitat Polak K, Dorner G, Kiss B, Polska E, Findl O, Rainer G et al (2000) Evaluation of the Zeiss retinal vessel analyser. Br J Ophthalmol 84:1285–1290PubMedCrossRef Polak K, Dorner G, Kiss B, Polska E, Findl O, Rainer G et al (2000) Evaluation of the Zeiss retinal vessel analyser. Br J Ophthalmol 84:1285–1290PubMedCrossRef
19.
Zurück zum Zitat Riva CE, Sinclair SH, Grunwald JE (1981) Autoregulation of retinal circulation in response to decrease of perfusion pressure. Invest Ophthalmol Vis Sci 21:34–38PubMed Riva CE, Sinclair SH, Grunwald JE (1981) Autoregulation of retinal circulation in response to decrease of perfusion pressure. Invest Ophthalmol Vis Sci 21:34–38PubMed
20.
Zurück zum Zitat Schmetterer L, Findl O, Fasching P, Ferber W, Strenn K, Breiteneder H et al (1997) Nitric oxide and ocular blood flow in patients with IDDM. Diabetes 46:653–658PubMedCrossRef Schmetterer L, Findl O, Fasching P, Ferber W, Strenn K, Breiteneder H et al (1997) Nitric oxide and ocular blood flow in patients with IDDM. Diabetes 46:653–658PubMedCrossRef
21.
Zurück zum Zitat Seifertl BU, Vilser W (2002) Retinal Vessel Analyzer (RVA)—design and function. Biomed Tech (Berl) 47 [Suppl 1 Pt 2]:678–681CrossRef Seifertl BU, Vilser W (2002) Retinal Vessel Analyzer (RVA)—design and function. Biomed Tech (Berl) 47 [Suppl 1 Pt 2]:678–681CrossRef
22.
Zurück zum Zitat Sinclair SH, Grunwald JE, Riva CE, Braunstein SN, Nichols CW, Schwartz SS (1982) Retinal vascular autoregulation in diabetes mellitus. Ophthalmology 89:748–750PubMed Sinclair SH, Grunwald JE, Riva CE, Braunstein SN, Nichols CW, Schwartz SS (1982) Retinal vascular autoregulation in diabetes mellitus. Ophthalmology 89:748–750PubMed
23.
Zurück zum Zitat Stansberry KB, Shapiro SA, Hill MA, McNitt PM, Meyer MD, Vinik AI (1996) Impaired peripheral vasomotion in diabetes. Diabetes Care 19:715–721PubMedCrossRef Stansberry KB, Shapiro SA, Hill MA, McNitt PM, Meyer MD, Vinik AI (1996) Impaired peripheral vasomotion in diabetes. Diabetes Care 19:715–721PubMedCrossRef
24.
Zurück zum Zitat Stefansson E, Landers MB III, Wolbarsht ML (1983) Oxygenation and vasodilatation in relation to diabetic and other proliferative retinopathies. Ophthalmic Surg 14:209–226PubMed Stefansson E, Landers MB III, Wolbarsht ML (1983) Oxygenation and vasodilatation in relation to diabetic and other proliferative retinopathies. Ophthalmic Surg 14:209–226PubMed
Metadaten
Titel
The blood pressure-induced diameter response of retinal arterioles decreases with increasing diabetic maculopathy
verfasst von
Christian Alcaraz Frederiksen
Peter Jeppesen
Søren Tang Knudsen
Per Løgstrup Poulsen
Carl Erik Mogensen
Toke Bek
Publikationsdatum
01.10.2006
Verlag
Springer-Verlag
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 10/2006
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-006-0262-1

Weitere Artikel der Ausgabe 10/2006

Graefe's Archive for Clinical and Experimental Ophthalmology 10/2006 Zur Ausgabe

Announcements

Announcements

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Die Verwendung von Ophthalmika in der Schwangerschaft und Stillzeit stellt immer eine Off-label-Anwendung dar. Ein Einsatz von Arzneimitteln muss daher besonders sorgfältig auf sein Risiko-Nutzen-Verhältnis bewertet werden. In der vorliegenden …

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Vitrektomie Originalie

Die endogene Endophthalmitis ist eine hämatogen fortgeleitete, bakterielle oder fungale Infektion, die über choroidale oder retinale Gefäße in den Augapfel eingeschwemmt wird [ 1 – 3 ]. Von dort infiltrieren die Keime in die Netzhaut, den …

Bakterielle endogene Endophthalmitis

Vitrektomie Leitthema

Eine endogene Endophthalmitis stellt einen ophthalmologischen Notfall dar, der umgehender Diagnostik und Therapie bedarf. Es sollte mit geeigneten Methoden, wie beispielsweise dem Freiburger Endophthalmitis-Set, ein Keimnachweis erfolgen. Bei der …

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Die bestmögliche Wundheilung der Kornea, insbesondere ohne die Ausbildung von lichtstreuenden Narben, ist oberstes Gebot, um einer dauerhaften Schädigung der Hornhaut frühzeitig entgegenzuwirken und die Funktion des Auges zu erhalten.   

Update Augenheilkunde

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