The authors investigated macular circulation in a group of 27 patients(54 eyes) with diabetes melitus to evaluate the change of macular blood flow according to the grade of retinopathy, the status of glucose control and the duration of diabetes. Blood volume, flow and velocity on macular area were measured by Heidelberg Retinal Flowmeter(HRF, Heidelberg Engineering). Paticents with moderate or severe diabetic retinopathy showed a significant increase in macular blood flow than patients with less degree of diabetic retinopathy(502.45+/-223.58 AU vs, 355.19+/-123.84 AU, p=0.003). Both blood volume and velocity were also significantly increased in the patients with more advanced diabetic retinopathy. Macular blood flow was increased in the patients with higher fasting blood glucose, although the statistical significance was in borderline(473.12+/-238.57 AU vs, 362.14+/-103.22 AU, p=0.066). These results show that macular blood flow increases in the diabetic patients with more advanced diabetic retinopathy, suggesting that the increase in the macular blood flow may play a role in the development of diabetic macular microangiopathy.
Blood Glucose ; Blood Volume ; Diabetic Retinopathy ; Fasting ; Glucose ; Humans ; Retinaldehyde

No abstract available.
Diabetes Mellitus, Type 2/*blood ; Diabetic Nephropathies/*blood ; Diabetic Retinopathy/*blood ; Hemoglobins/*metabolism ; Humans ; Male

PURPOSE: To evaluate the correlation between the severity of diabetic retinopathy, decrease of corneal sensitivity and conjunctival impression cytology. METHODS: 150 eyes of 75 patients were enrolled. The patients were divided into two groups. The study group is 110 eyes of 55 patients with diabetic retinopathy and the control group is 40 eyes of 20 patients without diabetic retinopathy. The hemoglobin A1C (HbA1C) and fasting plasma glucose (FPG) were measured for the index of diabetic control. Corneal sensitivity was measured with Cochet-Bonnet aesthesiometer, and conjuctival impression cytology and fundus examination were done in two groups after topical anesthesia instillation. The classification of diabetic retinopathy was based on the ETDRS. RESULTS: In corneal sensitivity, the study group was 3.8 +/- 3.6 g/mm2, the control group 1.1 +/- 2.16 g/mm2, showing statistically significant difference (p<0.05). The severity of diabetic retinopathy had negative correlation with corneal sensitivity (R2=0.26, p<0.05). Conjunctival impression cytology had negative correlation with corneal sensitivity (R2=0.41, p<0.05), and positive correlation with retinopathy (R2=0.26, p<0.05). Corneal sensitivity was affected by the hemoglobin A1C (p<0.01), but fasting plasma glucose (p=0.7). CONCLUSIONS: Conjucntival impression cytology had negaitive correlation with corneal sensitivity and positive correlation with diabetic retinopathy. It can be thought that corneal sensitivity is affected by chronic glycemic control.
Anesthesia ; Blood Glucose ; Classification ; Diabetic Retinopathy* ; Fasting ; Humans

A review has been made of 500 cases of which had been undertaken fundoscopic and slit lamp examination. Senile cataract in diabetics tends to be associated with diabetes of long duration. They were analyzed according to sex, age, duration, fasting blood sugar level, visual acuity and fundus findings. The results are obtained as follows. 1. Incidence of cataract among 500 cases of diabetics is 41%. 2. Prevalence of cataract is significantly associated with duration of diabetes(P<0.005). 3. Prevalence of cataract is significantly associated with age over 40. 4. Prevalence of cataract is significantly correlated with FBS level with duration of diabetes of under 5 years(r=0.8). 5. prevalence of cataract is significantly associated with visual acuity(p<0.005). 6. Diabetic Retinopathy was found in 50% of those with cataract
Blood Glucose ; Cataract* ; Diabetic Retinopathy ; Fasting ; Incidence ; Prevalence ; Visual Acuity

PURPOSE: Among electroretinogram variables, changes in OPs have frequently been reported as an early index of microcirculatory changes in diabetes mellitus patients without clinical signs of diabetic retinopathy. But studies on the relationship of hypertensive retinopathy and ERG have rarely been reported. This study was performed to investigate the relationship between retinal functional damage of hypertension and related changes in ERG. METHODS: Sixty-six essential hypertensive patients who visited our health screening center from January to July in 2001 were incruited as subjects. Among 122 eyes of 61 patients, 56 eyes with normal appearing retina were classified as group A while another 66 eyes with evidence of hypertensive retinopathy were as group B and 30 eyes of 15 persons of similar ages with normal blood pressure were normal control group as group C. Amplitude and implicit time were measured according to the standard electroretinogram procedure recommended by the ISCEV. RESULTS: In rod response, the amplitude of b wave of group A and B were smaller than that of group C(p<0.01), and the SOP of group A and B were also smaller than that of group C(p<0.01). The SOP of group B was smaller than that of group A(P<0.01). Regardless of degree of hypertension, the SOP value of group B was smaller than that of group A(P<0.01). Among patients with less than 5 years of duration, the SOP value of group B was smaller than that of group A(P<0.01). Among Group A with more than 5 years of duration, regardless of hypertensive retinopathy, the SOP was decreased. Among Group B with less than 5 years of duration, the SOP was also decreased regardless of retinopathy. CONCLUSIONS: Regardless of hypertensive retinopahy, scotopic b-amplitude and SOP were reduced in hypertension patients. Those patient with longer duration, decreased SOP was related to microcirculation alteration in hypertension despite normal appearing retina.
Blood Pressure ; Diabetes Mellitus ; Diabetic Retinopathy ; Humans ; Hypertension ; Hypertensive Retinopathy* ; Mass Screening ; Microcirculation ; Retina ; Retinaldehyde

PURPOSE:To compare macular thickness and visual acuity before and after panretinal photocoagulation in patients with severe diabetic retinopathy without diabetic macular edema. METHODS: Macular thickness and visual acuity (LogMAR) of 40 eyes were compared before and after panretinal photocoagulation, for severe diabetic retinopathy. Macular thickness was measured by optical coherence tomography(OCT). In addition, changes in macular thickness and visual acuity were compared with the patient's level of HbA1c, blood pressure, and diabetic nephropathy. RESULTS: Mean visual acuity before and 1.47+/-0.80 months after panretinal photocoagulation were 0.28+/-0.23 and 0.33+/-0.27, respectively, which was not a significant decrease (p=0.131). However mean central macular thickness (216.98+/-34.09 microm to 255.22+/-73.40 microm), and mean peripheral macular thickness (269.26+/-34.59 microm to 291.96+/-46.49 microm) did increase significantly after panretinal photocoagulation (p=0.001). The decrease of mean visual acuity and increase of mean macular thickness were greater in patients with high blood glucose, high blood pressure and diabetic nephropathy. CONCLUSIONS: In eyes with severe diabetic retinopathy treated with panretinal photocoagulation, mean visual acuity did not decrease significantly, but mean central and peripheral macular thickness significantly increased after treatment. We posit that visual prognosis after panretinal photocoagulation in eyes with severe diabetic retinopathy without macular edema is influenced by the control of blood glucose and blood pressure and the presence of diabetic nephropathy.
Blood Glucose ; Blood Pressure ; Diabetic Nephropathies ; Diabetic Retinopathy ; Eye ; Humans ; Hypertension ; Light Coagulation ; Macular Edema ; Prognosis ; Visual Acuity

In the condition of diabetic retinopathy, the vascular changes are localized primarily in the retinal capillaries and are presumed to promote angiogenesis. To investigate the change of retinal blood flow velocities and morphological parameters in diabetic retinopathy, we measured perifoveal capillary blood velocities(v) and the size of foveal avascular zones(FAZ). Thirteen patients with diabetic maculopathy and nine healthy volunteers were included in this study. The scanning laser technique in conjunction with an image analysing system were used to assess the morphological and hemodynamic changes in diabetic retinopathy. Diabetic maculopathy group showed a slower capillary blood velocity than normal group(2.44+/-0.39mm/sec vs2.75+/-0.61 mm/sec, p>0.18). The foveal avascular zone was significantly larger in diabetic maculopathy group than in normal group(313.5+/-64.6micrometervs. 238.9+/-93.8micrometer, p<0.05). This results indicate that the retinal microcirculation is altered in diabetic patients compared with healthy subjects. These alterations may be due to the change of the capillary wall and blood viscosity in diabetic patients. The determination of these parameters can be utilized in monitoring the progress of diabetic maculopathy.
Blood Flow Velocity ; Blood Viscosity ; Capillaries ; Diabetic Retinopathy ; Healthy Volunteers ; Hemodynamics ; Humans ; Microcirculation ; Retinaldehyde

It has been well known that diabetic retinopathy is related to proteinuria in diabetes. However there still remains a controversy regarding the association between microalbuminuria and diabetic retinopathy. To know the effect of microalbuminuria on the development of diabetic retinopathy, we studied the presence of microalbuminuria in 80 diabetic patients who had no proteinuria or a history of renal disease were included in this study. We examined 24 hour microalbuminuria by radioimmunoassay and examined the presence and severity of diabetic retinopathy. Among the total of 80 patients with diabetes, microalbuminuria[20microgram/min] was found in 40%[32 patients] and diabetic retinopathy was in 46.3%[37 patients]. The prevalence of microalbuminuria was higher in diabetic retinopathy group[73.0%, 27 of 37 patients] than in normal control group[11.6%, 5 of 43 patients][p<0.001]. The amount of microalbuminuria showed significant correlation with the severity of diabetic retinopathy[r=0.461, p<0.001]. Duration of diabetes was significantly longer in diabetic retinopathy group than in normal group[10.8+/-5.3 years vs 4.8+/-4.1 years, p<0.001]. There was no statistical significance in blood pressure, fasting blood sugar, HbA1 C, serum cholesterol or lipid between the two groups. With these above results, we suggest that microalbuminuria may be associated with the development of diabetic retinopathy in diabetes and thus, microalbuminuria may be a useful marker for the early detection of diabetic retinopathy.
Blood Glucose ; Blood Pressure ; Cholesterol ; Diabetic Retinopathy* ; Fasting ; Hemoglobin A, Glycosylated ; Humans ; Prevalence ; Proteinuria* ; Radioimmunoassay

BACKGROUNDNumerous studies have investigated the association between adiponectin concentrations and diabetic retinopathy (DR) caused by type 2 diabetic mellitus. However, the results remain conflicting. We performed a meta-analysis to explore the relationship between adiponectin concentrations and risk of DR caused by type 2 diabetic mellitus from published articles.

METHODSA published literature search was performed through the PubMed, Cochrane Library, EMBASE, Science Citation Index Expanded database, Chinese CNKI, and Chinese Wan Fang databases for articles published in English and Chinese. Pooled standardized mean differences (SMDs) and 95% confidence intervals (95% CIs) were calculated using random or fixed effects model. Heterogeneity between studies was assessed using the Cochrane Q test and I(2) statistics.

RESULTSNineteen studies with a total of 1 545 cases and 1 502 controls were retrieved. The original meta-analysis found a significant difference in the adiponectin concentrations between the DR and non-DR (NDR) groups. After excluding the high heterogeneity studies, the second meta-analysis also demonstrated the significant association (SMD (95% CI) = -0.62 (-0.80 to -0.44), P = 0.0001). According to the available data, there was statistical significance in the adiponectin concentrations considering non-proliferative DR (NPDR) versus NDR, PDR versus NPDR in Chinese populations with high heterogeneity.

CONCLUSIONAdiponectin concentrations are correlated with DR; however, the relationship between adiponectin concentrations and DR needs more in-depth investigations with larger sample sizes.

PURPOSE: To verify the clinical correlation between retinopathy progression and the change of venous filling time (VFT), measured before and after panretinal photocoagulation (PRP), in proliferative diabetic retinopathy (PDR) patients. METHODS: We conducted this study on 32 patients (32 eyes) who received PRP for PDR. These patients were subdivided into two groups in accordance with the clinical course of PRP: the stabilized group in which retinal neovascularization was regressed and the progressed group in which retinal neovascularization was continued and a complication, such as vitreous hemorrhage or tractional retinal detachment, was developed within 12 months of laser treatment. Arteriovenous passage time (AVP) and VFT were measured by video fluorescein angiogram (FAG) using scanning laser ophthalmoscope (SLO) before and after PRP. VFT values were assigned by measuring by the time duration from start of venous lamina flow to the fullness of fluorescence on the vascular arch. RESULTS: In the stabilized group, AVP was decreased by 0.20+/-0.89sec and VFT was decreased by 0.30+/-1.69 sec through PRP. In the progressed group, AVP was increased in 0.12+/-1.22 sec and VFT was increased by 0.99+/-1.60 sec through PRP. In both groups, the VFT changes were significant (P=0.04) but the AVP changes were not (P=0.34). CONCLUSIONS: VFT was significantly decreased in the stabilized group and significantly increased in the progressed group after PRP. Accordingly, we suggest that VFT changes after PRP can be utilized as a prognostic indicator for evaluating clinical course of diabetic retinopathy after performing PRP and for monitoring the clinical effect of PRP.
Veins ; Time Factors ; Retinal Vessels/*physiopathology ; Regional Blood Flow ; *Light Coagulation ; Humans ; Diabetic Retinopathy/*physiopathology/*surgery