No abstract

Our results indicate that DVA directly reflects the actual metabolic status of the retinal endothelium. DVA might be used as an early noninvasive screening tool to detect vascular dysregulation and pan-endothelial dysfunction in patients with HT.

Background and Objectives: The goal was to evaluate the association of dynamic retinal vessel analysis (DVA) with echocardiographic parameters assessing systolic and diastolic function of the left ventricle in hypertension (HT) patients with preserved left ventricle ejection fraction. Materials and Methods: This observational retrospective study recruited 36 patients with HT and 28 healthy controls. Retinal vessel diameter and reactions to flicker light were examined. Each patient was examined with echocardiography to assess left ventricular systolic and diastolic function. Results: Multivariate analysis revealed that hypertension was an independent factor associated with lower flicker-induced arterial vasodilatation (β = −0.31, p = 0.029). In the HT group, there was a significant positive association between left ventricular ejection fraction and flicker-induced arterial vasodilation (Rs = +0.31, p = 0.007). Additionally, end-diastolic left ventricular diameter negatively correlated with both arterial (Rs = −0.26, p = 0.02) and venous (Rs = −0.27, p = 0.02) flicker responses. Additionally, the echocardiographic characteristics of the left atrium (LA) remodeling in the course of HT, including the area of the LA and its antero-posterior dimension, were both negatively correlated with the arterial flicker response (Rs = −0.34, p = 0.003; Rs = −0.33, p = 0.004, respectively). From tissue Doppler parameters, the left ventricular filling index E/e’ negatively correlated with AVR (arteriovenous ratio) values (Rs = −0.36, p = 0.002). Conclusions: We revealed that systolic and diastolic function of the left ventricle in hypertensive patients is associated with retinal microvascular function.

Aim: Clinically detectable signs of diabetic retinopathy are preceded by endothelial dysfunction. Retinal microvasculature dynamics assessment using a dynamic vessel analyzer (DVA) may enable detection of neurovascular changes in vivo at the preclinical stage of diabetic complications and thus may help to recognize patients at increased risk of diabetic retinopathy. The aim of the study was to investigate the response of retinal vessels to flickering light in diabetic patients without clinically detectable diabetic retinopathy. Materials and methods: Eighty eyes of 40 patients with type II diabetes and no clinically detectable diabetic retinopathy were enrolled in the study group. The control group consisted of 44 volunteers (88 eyes) without diabetes. The Dynamic Vessel Analyzer (DVA) was used to measure retinal vascular dilatation in response to flicker light stimulation. Results: The AVR obtained by static vessel analysis was similar in both groups, whereas retinal vascular dilation after flicker stimulation in arterioles and veins was significantly reduced in the DM group (mean of 1.79% and 3.24%, respectively) compared with the control group (mean of 2.86% and 4.07%, respectively). DM was an independent factor associated with lower values of the flicker-light-induced vasodilation. A slight positive correlation was noted between the time of physical activity and better arterial response to flicker light in the diabetic group (Rs = +0.34, p = 0.03). Conclusions: 1. Retinal vessel reactivity to flicker light stimulation is reduced in diabetic patients with no clinically detectable signs of diabetic retinopathy. 2.DVA may be a valuable tool for early identification of patients at increased risk of diabetic retinopathy.