Early FDG-PET predicts PFS, OS, and nonprogression after 6 weeks of therapy with erlotinib in unselected, previously untreated patients with advanced NSCLC independent from EGFR mutational status.

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Arterial hypertension is known to be an important risk factor for cerebral and cardiovascular disease. Previous studies in rats have demonstrated that changes in both capillary density and vessel diameter may contribute to increased vascular resistance in hypertension. In vivo studies of human subjects with essential hypertension revealed a reduction in the number of arterioles in the skin and conjunctiva; no other in vivo data are available from other tissues. By means of a new imaging technique, capillary density and capillary blood flow velocity can now be assessed in the human retina. We undertook the present investigation to determine whether patients with essential hypertension and only minor clinical retinal vascular alterations have decreased retinal capillary density and altered capillary flow velocity. Seventeen hypertensive patients with only minor retinal vascular alterations and 17 healthy volunteers matched for age were selected. All study participants under-E ssential hypertension is an important risk factor for the development of cerebral, coronary, and peripheral artery disease. Previous studies have demonstrated that changes in both capillary density 1 3 and vessel diameter 4 -5 may contribute to increased vascular resistance in hypertension. In vivo studies in human subjects with essential hypertension revealed a reduction in the number of arterioles in the bulbar conjunctiva 6 -7 and of capillaries in the nailfold. 8However, these studies gave data on only the microvasculature of the skin and conjunctiva. Until now, examination of the retina allowed only for determination of vascular changes in arterioles. hypertension. By means of new imaging techniques" capillary density and capillary blood flow velocity can now be assessed in the human retina. 12 We undertook the present investigation to determine whether patients with essential hypertension and only minor retinal vascular alterations have decreased retinal capillary density and altered capillary flow velocity. Methods Study PopulationSixty-five patients with essential hypertension who were followed at the outpatient department of the University Hospital Aachen were recruited for the study. Each patient had a well-established history of chronically elevated blood pressure (> 145/95 mm Hg) without any apparent underlying cause and had been treated for at least 2 years with one or more antihypertensive agents. After ophthalmologic examination 17 patients with retinal vascular alterations of stage 1 of the Neubauer classification 13 were included in the study. Stage 1 of the Neubauer classification represents the earliest fundus changes due to hypertension, with only minimal narrowing of the retinal arteries. Patients with diabetes mellitus or systolic hypertension were excluded from the study.Diagnosis was established in all 17 hypertensive patients by complete clinical, laboratory, and radiographic investigations, including renal angiography. None had cardiac or renal failure. A population of 11 men and 6 women, matched with the pa...

Video fluorescein angiography was performed in 124 patients between 18 and 65 years of age (mean 35 0, SD 12-3 years) with juvenileonset, insulin-dependent diabetes mellitus (type 1). The arm-retina time (ART) and the retinal arteriovenous passage time (AVP) were measured by means of a picture analysis system to quantify the retinal microcirculation. Glucose metabolism was assessed by the blood level of haemoglobin AIc. The ART 11-5, SD 3-4 s) was similar to that in normal persons (11.2, SD 3-3 s), while the AVP was significantlylongerin the diabetics (AVP=2.35, SD 0-87 s) than in normal persons (AVP= 1-45, SD 040 s). The patients with severe diabetic retinopathy showed the most impressive change in AVP. The diabetics with good glycaemic control, that is, with glycosylated haemoglobin (HbAlc) 68-0 g/dl, had a shorter AVP than patients with bad glycaemic control (HbAlc Bt9-5 g/dl). The group with a history of diabetes for less than five years showed circulation parameters similar to those of normal persons. The AVP in this group was significantly shorter than in groups with a history of diabetes for five or more years.Most patients with diabetes mellitus develop characteristic abnormalities of the retinal blood vessels and the blood rheology. These abnormalities seem to alter the retinal blood flow in diabetic persons.Video fluorescein angiography, combined with a picture analysing system, is a clinically applicable objective method for evaluating retinal circulation parameters.' Until August 1989 the system included a low light videocamera (Bosch) and a fundus camera (C Zeiss). Thereafter both devices were replaced by a scanning-laser-ophthalmoscope (SLO, Rodenstock). This new SLO gave similar results.2 The measuring technique used has been presented in detail elsewhere. The present paper reports the measurement of retinal circulation in juvenileonset insulin dependent diabetic persons (type 1) by means of video fluorescein angiography.

The hemodynamic status of 26 patients with retinitis pigmentosa was examined using video fluorescein angiography. The hemorheological parameters hematocrit, plasma viscosity, erythrocyte aggregation and erythrocyte rigidity were determined. The results were compared to a matched pairs-group. Video angiography showed for retinitis pigmentosa patients a normal arm-retina time and a significant increase of the arteriovenous passage time. The rheological parameters for both groups were within the reference range. Interestingly the hemodynamic disturbance of microcirculation could be demonstrated already in early stages with no ophthalmoscopic symptoms and no atrophy of retinal vessels detectable at the time. The results indicate that disturbance of the retinal hemodynamics in early stages of retinitis pigmentosa may play a role in the pathogenesis of the disease.

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