Retinal arteriolar diameter, blood velocity, and blood flow response to an isocapnic hyperoxic provocation in early sight-threatening diabetic retinopathy
Retinal arteriolar diameter, blood velocity, and blood flow response to an isocapnic hyperoxic provocation in early sight-threatening diabetic retinopathy
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DOI：
10.1167/iovs.06-1016
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发表时间：
2007-04-01
影响因子：
4.4
通讯作者：
Devenyi, Robert G.
中科院分区：
文献类型：
--
作者：
Gilmore, Edward D.;Hudson, Chris;Devenyi, Robert G.
目的.量化按视网膜病变严重程度分层的糖尿病患者和年龄匹配的对照受试者的视网膜小动脉血管反应性的大小。样本包括21名非糖尿病对照受试者（第1组），19名患者没有临床上可见的DR（第2组），19名患者轻度至中度非增殖性DR，没有临床上明显的糖尿病黄斑水肿（DME）（第3组），和17名患者DME（第4组）。视网膜小动脉直径和血流速度的测量是错误的。第3组和第4组的血流速度和壁剪切率（WSR）的变化显著小于第1组和第2组（分别为P < 0.0001和P = 0.0002）。第4组的血流量变化明显小于第1组和第2组（P < 0.004）。第2组和第4组中最大值与最小值（最大值：最小值）比值的变化显著小于第1组（P = 0.001）。基线客观水肿指数与血管反应性之间存在显著相关性。与无糖尿病的受试者相比，临床上明显DR的受试者对等二氧化碳过氧化反应的血管反应性程度降低。血管反应性的差异发生在基线血流动力学值无任何差异的情况下。在早期威胁视力的DR中，血管反应性受损，这种受损与客观定义的视网膜水肿程度有关。
PURPOSE. To quantify the magnitude of retinal arteriolar vascular reactivity in diabetic patients stratified by severity of retinopathy and in age-matched control subjects. The sample comprised 21 nondiabetic control subjects (group 1), 19 patients with no clinically visible DR (group 2), 19 patients with mild-to-moderate nonproliferative DR and without clinically evident diabetic macular edema (DME) (group 3), and 17 patients with DME (group 4).METHODS Subjects initially breathed air, followed by oxygen, while isocapnia was maintained. Retinal arteriolar diameter and blood velocity measurements were acquired simultaneously.RESULTS. Changes in blood velocity and wall shear rate (WSR) were significantly less in groups 3 and 4 (P < 0.0001 and P = 0.0002, respectively) than in groups 1 and 2. Change in blood flow was significantly less in group 4 (P < 0.004) than in groups 1 and 2. The change in maximum-to-minimum (max: min) ratio was significantly less in groups 2 and 4 than in group 1 (P = 0.001). There was a significant relationship between baseline objective edema indices and vascular reactivity. The magnitude of vascular reactivity in response to isocapnic byperoxia was reduced in those individuals with clinically evident DR relative to subjects without diabetes.CONCLUSIONS. The differences, in vascular reactivity occurred in the absence of any difference in baseline hemodynamic values. Vascular reactivity is impaired in early sight-threatening DR, and this impairment is related to the objectively defined magnitude of retinal edema.