Distribution of Capillary Nonperfusion in Early-stage Diabetic Retinopathy

Niki, Takashi; Muraoka, Kanemitsu; Shimizu, Koïchi

doi:10.1016/s0161-6420(84)34126-4

Cited by 114 publications

(68 citation statements)

References 4 publications

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“…The few papers that assess the balance of patients with glucose metabolism disorder find electronystagmography alterations in 27.1% to 43.8% of patients with glucose metabolism impairment [4][5][6][7][8][9][10][11][12] . These data confirm our findings so far raised in this pilot study.…”

Section: Discussionmentioning

confidence: 99%

“…The high costs of the insulinemia curve test and the fact that the American Association of Diabetes has not yet standardized it, have led us to carry out its indirect evaluation through the glycemia curve, of which results have so far been similar [6][7][8][9][10][11][12] .…”

Section: Discussionmentioning

confidence: 99%

“…And the populations above 75 years of age have prevalence levels varying between 30 and 35% 1,[6][7][8][9][10][11][12] .…”

Section: Discussionmentioning

confidence: 99%

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Correlação entre tontura e disfunções do metabolismo da glicose

Fonseca

Davidsohn²

2006

Rev. Bras. Otorrinolaringol.

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Introducti on: Impaired glucose metabolism is characterized by conditions of hypo and hyperglycemia. Aim: The objective of the present study was to asses whether or not there is a relationship between impaired glucose metabolism and dizziness. In the clinical laboratory settings, patients were examined using vectoelectronystagmography in association with glycemic levels. Methods: 33 patients were divided in 3 groups: diabetics; patients with dizziness and a control group. Results:65% of the patients with dizziness showed impaired glucose metabolism. 40% of the patients with dizziness had alterations in their vectoelectronystagmography results. Conclusion: Dizziness is a good indicator of glucose metabolism alterations and these may be a good indicator of alterations in vectoelectronystagmography responses. The study of glycemic levels after glucose overexposure is a good prognosis factor to evaluate dizziness and shows the same results as insulin level studies after glucose overexposure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Correlação entre tontura e disfunções do metabolismo da glicose

Fonseca

Davidsohn²

2006

Rev. Bras. Otorrinolaringol.

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“…The pattern of the vascular loss in the monkeys was noteworthy because the capillary network on the nasal side of the fovea is lost, whereas capillaries on the temporal side of the fovea remained viable. Capillary nonperfusion within 1.5-2.5 DD nasal to the optic disc is known to proceed rapidly and involve the farther periphery in some human subjects with diabetes (26), whereas the peripapillary zone (Ͻ1 DD away from the disc margin) was consistently spared from vasoocclusions (27). In the spontaneously diabetic monkeys, the temporal peripapillary zone was spared in three of the four monkeys with severe retinopathy but these spared vessels were cilioretinal in origin (21).…”

Section: Fig 5 Linear Regression Analysis Of Polymorphonuclear Leukmentioning

confidence: 99%

Neutrophils Are Associated With Capillary Closure in Spontaneously Diabetic Monkey Retinas

et al. 2005

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Type 2 diabetes develops spontaneously in obese aging rhesus monkeys (Macaca mulatta). This study investigates the association between polymorphonuclear leukocytes and development of retinopathy. Blood pressure and plasma glucose levels were determined in 15 diabetic and 6 nondiabetic monkeys. The plasma levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were determined just before the start of the animal's final decline and elective necropsy. Retinas were incubated for ADPase (labels viable retinal blood vessels) and nonspecific esterase (labels neutrophils) activities. Polymorphonuclear leukocytes were counted per millimeter squared of retina. After the retina was flat-embedded in glycol methacrylate, tissue sections were taken through areas of interest and observed microscopically. Elevated numbers of intravascular polymorphonuclear leukocytes were present adjacent to areas with retinal capillary nonperfusion. There were significantly more polymorphonuclear leukocytes per millimeter squared in diabetic retinas (6.91 ؎ 5.01) compared with normal retinas (1.45 ؎ 1.62, P ‫؍‬ 0.018). Severity of hypertension in diabetes was also significantly associated with greater numbers of polymorphonuclear leukocytes (P ‫؍‬ 0.02). There was a significant positive exponential correlation between the number of polymorphonuclear leukocytes per millimeter squared and the level of total cholesterol (R ‫؍‬ 0.907), LDL cholesterol (R ‫؍‬ 0.875), the total cholesterol-to-HDL cholesterol ratio (R ‫؍‬ 0.86), and total triglycerides (R ‫؍‬ 0.888). This study demonstrates that severity of diabetes and the development of retinopathy are associated with increased numbers of polymorphonuclear leukocytes in the retina of diabetic monkeys. Hypertension, high plasma levels of LDL cholesterol and triglycerides, and low plasma levels of HDL cholesterol also are associated with increased polymorphonuclear leukocytes in retina. Diabetes 54:1534 -1542, 2005 A n early event in diabetic retinopathy is retinal capillary nonperfusion. Recent evidence suggests that leukocytes may initiate vaso-occlusion in diabetic retinal microvasculature (1). Miyamoto et al. (2) and Ogura (3) used acridine orange labeling and a scanning laser ophthalmoscope to observe leukocytes in diabetic rats. The number of leukocytes trapped in the retinal microcirculation was significantly elevated in streptozotocin-induced diabetic rats (2.5-fold) and Otsuka Long-Evans Tokushima Fatty (OLETF) rats (2-fold) in the early stages of diabetes compared with nondiabetic rats. They hypothesized that accumulation of leukocytes in diabetic retinas during the preretinopathy stage could cause microvascular occlusions and dysfunction, in turn causing retinopathy. Barouch et al. (4) later demonstrated that the increase in leukocyte accumulation or leukostasis was dependent on the adhesion molecule responsible for modulating firm adherence of leukocytes to endothelial cells, intracellular adhesion molecule-1 (ICAM-1), which is elevated in human diabetic retina (...

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“…Manual photomontages are created by cutting and pasting photographic prints or by overlapping and blending their digitized images with photo-editing software. [14][15][16] Higher resolution is achievable with wide-field manual photomontages, 17,18 but their preparation is lengthy and laborious. The HRA Eye Explorer software automates photomontage preparation, producing photomontages that range from 100°to 140°.…”

Section: Commentmentioning

confidence: 99%

Scanning Laser Ophthalmoscopy and Angiography With a Wide-Field Contact Lens System

et al. 2005

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To perform fluorescein and indocyanine green angiography for large or peripheral chorioretinal structures using a contact lens system that provides a 5-fold increase in the field of view of a confocal scanning laser ophthalmoscope (SLO).Methods: Separate handheld contact and noncontact ophthalmoscopic lenses were manually aligned with the optical axis of a confocal SLO to demonstrate the feasibility of wide-field SLO angiography. An integrated, widefield contact lens system was then designed and constructed to increase the SLO's 10°, 20°, and 30°imaging fields to 50°, 100°, and 150°, respectively.Results: Simultaneous fluorescein and indocyanine green angiography was performed with the integrated, widefield contact lens system for more than 50 patients with disorders that affect their peripheral retina and choroid. Retinal and choroidal abnormalities, including neovas-cularization and capillary nonperfusion, are easily detected and documented well beyond the range of conventional fundus cameras and SLOs. Peripheral retinal and choroidal hemodynamics can be readily observed and recorded.Conclusions: A confocal SLO has adequate resolution for clinically useful reflectance and angiographic imaging even when its field size is increased 5-fold by a widefield contact lens system. Dynamic and static wide-field angiography can be performed without the limitations of manual or computer-automated photomontages. Peripheral retinal conditions can be studied and recorded to confirm observations from indirect ophthalmoscopy and to facilitate retinal photocoagulation and vitreoretinal surgery.

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Distribution of Capillary Nonperfusion in Early-stage Diabetic Retinopathy

Cited by 114 publications

References 4 publications

Correlação entre tontura e disfunções do metabolismo da glicose

Correlação entre tontura e disfunções do metabolismo da glicose

Neutrophils Are Associated With Capillary Closure in Spontaneously Diabetic Monkey Retinas

Scanning Laser Ophthalmoscopy and Angiography With a Wide-Field Contact Lens System

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