Capillary pressure may predict preclinical changes in the eye

Abstract

Aims/hypothesisMicrovascular dysfunction is associated with end-organ damage. Macular oedema is an important component of diabetic retinopathy. Macular thickness can be accurately quantified by optical coherence tomography (OCT), enabling accurate assessment of the macular prior to clinically apparent abnormalities. We investigated whether macular (fovea) thickness in non-diabetic individuals is related to the microvascular variables controlling fluid filtration across a blood vessel wall, in particular capillary pressure and the microvascular filtration capacity (Kf).MethodsWe recruited 50 non-diabetic individuals (25 men, 25 women; age range: 26–78 years; BMI range: 20–46 kg/m2). Fovea thickness was assessed by OCT. Microvascular assessments included: finger nailfold capillary pressure; Kf; microvascular structural assessments, i.e. skin vasodilatory capacity, minimum vascular resistance (MVR) and microvascular distensibility; and endothelial function.ResultsAt 214.6 (19.9) µm (mean [SD]), fovea thickness was within normal range. Capillary pressure, adjusted for BMI, was associated with fovea thickness (standardised beta 0.573, p = 0.006, linear regression). Fovea thickness was not associated with Kf, microvascular structural assessments or endothelial function. Capillary pressure was still associated with fovea thickness when adjusted for microvascular variables (Kf, vasodilatory capacity, MVR, microvascular distensibility or endothelial function), or for risk factors for diabetes (systemic blood pressure, insulin sensitivity, inflammation, glycaemic status and lipids) and age.Conclusions/interpretationCapillary pressure, a key determinant of movement of fluid across a blood vessel wall, is associated with fovea thickness in non-diabetic individuals. This suggests that with regard to potential preventative or therapeutic targets, attention should be directed at the mechanisms determining retinal microvascular pressure.Electronic supplementary materialThe online version of this article (doi:10.1007/s00125-010-1805-x) contains supplementary material, which is available to authorised users.

Holographic laser Doppler imaging of microvascular blood flow

“…The role of the microcirculation is increasingly being recognized in the pathophysiology of cardiovascular diseases; eg. hypertension [1][2][3] and diabetes [4][5][6]. In particular, assessing retinal blood flow can be potentially useful for understanding diabetic retinopathies [7], and study the relationships between vascularization and glaucoma [8][9][10][11][12].…”

The Association of Systemic Microvascular Changes with Lung Function and Lung Density: A Cross-Sectional Study

“…While it is known that smoking-related microvascular disease contributes to end-organ damage in the brain, kidney, heart and eyes [7], [8], it is unclear whether similar microvascular changes in the lung may contribute to COPD pathogenesis.…”

Correlation between Thyroid Endocrine Status, Change in Body Weight and Macular Thickness in Obese Patients

“…Every patient underwent a complete ophthalmic examination, only those ones with best corrected visual acuity (BCVA) of 20/20 clear media, refractive error in the range between -3 D and +3 D (measured as spherical equivalent), normal retina status in both eyes and no history or evidence of either systemic or ophthalmic disease were included [7].…”

“…Micro-vascular anomalies have been proved to be related to macular thickening in non-diabetic patients measured with ocular coherence tomography (OCT) [7]. This is the first paper studying correlation among body and blood parameters changes versus macular thickness variation in obese patients after 3 months from starting a hypo caloric diet.…”