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Patients with diabetic retinopathy have high retinal venous pressure.

ABSTRACT: BACKGROUND:The introduction of ophthalmodynamometric measurement of retinal venous pressure (RVP) now permits the quantification, or at least an approximation, of the real pressure in the retinal veins. METHODS:We measured the RVP of healthy control subjects, patients with diabetes without diabetic retinopathy (nonDR) and patients with diabetes and diabetic retinopathy (DR). RESULTS:The mean?±?SD RVP for the control, nonDR and DR groups were 23.4?±?7.33, 22.5?±?5.78 and 37.7?±?10.1 mmHg, respectively. In the diabetes patients with DR, the RVP was markedly and significantly increased, and this result was significantly age dependent. RVP was not increased in the group of diabetes patients without DR. In our tested population, diabetes had a minor influence on intraocular pressure. CONCLUSION:Regardless of the cause, a marked increase in RVP in diabetes patients with DR is clinically relevant, as it reduces perfusion pressure and increases transmural pressure. The reduced perfusion pressure contributes to hypoxia, and the increased transmural pressure can facilitate retinal edema. Diabetes is an increasing burden, and DR is one of its most severe complications. Strategies to recognize the risk for DR and to develop personalized prevention and therapy therefore have major implications. TRIAL REGISTRATION:ClinicalTrials.gov ID: NCT01771835.

SUBMITTER: Cybulska-Heinrich AK

PROVIDER: S-EPMC4365968 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Patients with diabetic retinopathy have high retinal venous pressure.

Cybulska-Heinrich Anna K AK Baertschi Michael M Loesche Cay Christian CC Schoetzau Andreas A Konieczka Katarzyna K Josifova Tatjana T Flammer Josef J

The EPMA journal 20150224 1

<h4>Background</h4>The introduction of ophthalmodynamometric measurement of retinal venous pressure (RVP) now permits the quantification, or at least an approximation, of the real pressure in the retinal veins.<h4>Methods</h4>We measured the RVP of healthy control subjects, patients with diabetes without diabetic retinopathy (nonDR) and patients with diabetes and diabetic retinopathy (DR).<h4>Results</h4>The mean ± SD RVP for the control, nonDR and DR groups were 23.4 ± 7.33, 22.5 ± 5.78 and 37. ...[more]

PMID: 25793018

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Project description:ObjectivesTo determine the risk factors for retinal microvascular impairment on optical coherence tomography angiography (OCT-A) in type 2 diabetic patients without clinical diabetic retinopathy (DR).MethodsThis retrospective and cross-sectional study enrolled 74 diabetic patients without clinically evident DR for the study group and 34 healthy subjects for the control group. OCT-A parameters were measured to determine vascular density (VD) and the foveal avascular zone (FAZ) size in the superficial and deep capillary plexuses (SCP/DCP) of the retina. Clinical data were collected on sex, age, diabetes duration, hemoglobin A1c (HbA1c), hypertension, dyslipidemia, low-density lipoprotein cholesterol (LDL-C), estimated glomerular filtration rate (eGFR) and smoking status. Multiple linear regression analyses were performed to represent the associated clinical variables with OCT-A parameters in diabetic patients.ResultsIn comparison between the study and control groups, the VD in the SCP and DCP were significantly lower in diabetic patients compared to the controls (P = 0.022 and 0.003, respectively). The FAZ size in the SCP and DCP were significantly greater in diabetic patients compared to the controls (P = 0.035 and <0.001, respectively). In age- and sex-adjusted multiple regression analyses for the diabetic patients, dyslipidemia and hypertension were negatively associated with SCP-VD (β = -0.357, P = 0.002; β = -0.239, P = 0.039, respectively). Current smoking was correlated with lower DCP-VD (β = -0.255, P = 0.043). Greater SCP-FAZ size was associated with dyslipidemia and greater LDL-C (β = 0.254, P = 0.013; β = 0.232, P = 0.029, respectively), and greater DCP-FAZ size, with lower eGFR and greater LDL-C (β = -0.355, P = 0.004; β = 0.235, P = 0.037, respectively).ConclusionsDiabetic patients without clinical DR showed lower VD and greater FAZ size in the SCP and DCP compared to healthy controls. In diabetic patients without clinical DR, dyslipidemia and/or high LDL-C were important risk factors for retinal microvascular impairment. Hypertension, current smoking and lower eGFR also contributed to microvascular impairment.

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Patients with diabetic retinopathy have high retinal venous pressure.

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Patients with diabetic retinopathy have high retinal venous pressure.

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