Vascular endothelial growth factor and severity of nonproliferative diabetic retinopathy mediate retinal hemodynamics in vivo: A potential role for vascular endothelial growth factor in the progression of nonproliferative diabetic retinopathy
Vascular endothelial growth factor and severity of nonproliferative diabetic retinopathy mediate retinal hemodynamics in vivo: A potential role for vascular endothelial growth factor in the progression of nonproliferative diabetic retinopathy
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DOI：
10.1016/s0002-9394(14)70860-8
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发表时间：
1997-10-01
影响因子：
4.2
通讯作者：
Bursell, SE
中科院分区：
文献类型：
--
作者：
Clermont, AC;Aiello, LP;Bursell, SE
目的：观察血管内皮生长因子和视网膜病变水平对非糖尿病和糖尿病大鼠视网膜血流动力学的影响，评价非糖尿病和糖尿病大鼠视网膜血流动力学。方法：根据早期治疗糖尿病视网膜病变研究（ETDRS）， 48名糖尿病患者和22名非糖尿病患者通过眼底照片确定其糖尿病视网膜病变水平。用视频荧光素血管造影法记录左眼荧光素血管造影。通过数字化血管图计算视网膜血流量。将人重组血管内皮生长因子或载体单独注射到13只非糖尿病大鼠和11只糖尿病大鼠体内。结果：ETDRS视网膜病变水平为10级的患者视网膜血流量较对照组下降33% (P = .001)，在视网膜病变更晚期的患者视网膜血流量依次增加，且视网膜血流量与视网膜病变水平有很强的相关性（r(2) = 0.434, P = .001）。糖尿病大鼠视网膜血流量减少35.6% （P = 0.01）。血管内皮生长因子在25分钟后最大程度地增加了非糖尿病大鼠的视网膜血流量36.1% (P = 0.001)，在糖尿病大鼠仅5分钟后最大程度地增加了73.7% (P = 0.01)，糖尿病大鼠的反应比非糖尿病大鼠更大。结论：视网膜血流量随着人类非增殖性糖尿病视网膜病变的进展而增加，糖尿病加剧了血管内皮生长因子诱导的大鼠视网膜血流量和静脉扩张的增加。血管内皮生长因子可能参与了早期糖尿病视网膜病变视网膜血流动力学和形态学的改变。
PURPOSE: To determine the effect of vascular endothelial growth factor and retinopathy level on retinal hemodynamics in nondiabetic and diabetic rats and to evaluate retinal hemodynamics in nondiabetic and diabetic patients.METHODS: Forty-eight diabetic and 22 nondiabetic patients had their diabetic retinopathy levels determined from fundus photographs according to Early Treatment Diabetic Retinopathy Study (ETDRS). Fluorescein angiograms were recorded from the left eye by video fluorescein angiography. Retinal blood flow was calculated from the digitized angiograms. Human recombinant vascular endothelial growth factor or vehicle alone was injected intravitreally into 13 nondiabetic and 11 diabetic rats.RESULTS: Retinal blood flow decreased 33% in patients with ETDRS retinopathy level 10 compared with control patients (P = .001) and increased sequentially in more advanced stages of retinopathy, with a strong correlation between retinal blood flow and retinopathy level (r(2) = 0.434, P = .001). Tn the diabetic rats, retinal blood flow was decreased 35.6% (P = .01). Vascular endothelial growth factor maximally increased retinal blood flow by 36.1% in nondiabetic rats after 25 minutes (P = .001) and by 73.7% in diabetic rats after only 5 minutes (P = .01) and caused a greater response in diabetic than in nondiabetic rats.CONCLUSIONS: Retinal blood flow increases with advancing nonproliferative diabetic retinopathy in humans, and diabetes accentuates the vascular endothelial growth factor-induced increase in retinal blood flow and venous dilation in rats. Vascular endothelial growth factor may contribute to the changes in retinal hemodynamics and morphology observed in early diabetic retinopathy.