Reduced response of retinal vessel diameters to flicker stimulation in patients with diabetes

Garhöfer, Gerhard; Zawinka, Claudia; Resch, Hemma; Kóthy, Péter; Schmetterer, Leopold; Dorner, Guido T.

doi:10.1136/bjo.2003.033548

Cited by 202 publications

(166 citation statements)

References 25 publications

(11 reference statements)

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“…We demonstrated that the retinal vessel flicker response is diminished in diabetic patients compared with that in normal control participants. This finding is in agreement with a previous report indicating reduced flicker response in type 1 diabetic patients (28). We have also reported abnormal autoregulation in patients with type 2 diabetes.…”

Section: Retinal Vessel Flicker Response In Different Stages Of Diabesupporting

confidence: 83%

Influence of Flickering Light on the Retinal Vessels in Diabetic Patients

Mandecka

Dawczynski²,

Blum³

et al. 2007

Diabetes Care

178

149

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OBJECTIVE—Stimulation of the retina with flickering light increases retinal vessel diameters in humans. Nitric oxide is a mediator of the retinal vasodilation to flicker. The reduction of vasodilation is considered an endothelial dysfunction. We investigated the response of retinal vessels to flickering light in diabetic patients in different stages of diabetic retinopathy. RESEARCH DESIGN AND METHODS—We studied 53 healthy volunteers, 68 type 1 diabetic patients, and 172 type 2 diabetic patients. The diameter of retinal vessels was measured continuously online with the Dynamic Vessel Analyzer (DVA). Diabetic retinopathy was classified using Early Treatment Diabetic Retinopathy Study criteria. Changes in vasodilation are expressed as percent change over baseline values. RESULTS—After adjustments for age, sex, and antihypertensive treatment, the response of retinal arterioles to diffuse luminance flicker was significantly diminished in patients with type 1 diabetes compared with healthy volunteers. The vasodilation of retinal arterioles and venules decreased continuously with increasing stages of diabetic retinopathy. The retinal arterial diameter change was 3.6 ± 2.1% in the control group, 2.6 ± 2.5% in the no diabetic retinopathy group, 2.0 ± 2.7% in the mild nonproliferative diabetic retinopathy (NPDR) group, 1.6 ± 2.2% in the moderate NPDR group, 1.8 ± 1.9% in severe NPDR group, and 0.8 ± 1.6% in proliferative diabetic retinopathy group. CONCLUSIONS—Flicker responses of retinal vessels are abnormally reduced in diabetic patients. This decreased response deteriorated with increasing stages of retinopathy. The response was already reduced before clinical appearance of retinopathy. The noninvasive testing of retinal autoregulation with DVA might prove to be of value in early detection of diabetic vessel pathological changes.

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Section: Retinal Vessel Flicker Response In Different Stages Of Diabesupporting

confidence: 83%

Influence of Flickering Light on the Retinal Vessels in Diabetic Patients

Mandecka

Dawczynski²,

Blum³

et al. 2007

Diabetes Care

178

149

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“…20 In a study by Dorner and colleagues, 13 it was found that approximately 50% of the flicker light-induced increase in retinal arteriolar and venular vasodilatation can be blocked by L-NG-monomethyl arginine citrate infusion. Two studies have shown that the retinal microvascular response to flicker light is impaired under certain pathological conditions such DM 21,22 or essential hypertension. 15,23 It is suggested that in case of DM or hypertension, endothelial dysfunction and the restricted capability of the endothelial cell to secrete NO might cause a disturbed microvascular blood flow in several tissues prone to the development of microvascular complications.…”

Section: Discussionmentioning

confidence: 99%

Pilot Study for the Evaluation of Morphological and Functional Changes in Retinal Blood Flow in Patients with Insulin Resistance and/or Type 2 Diabetes Mellitus

Forst

Weber

Mitry³

et al. 2012

J Diabetes Sci Technol

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“…Abnormalities in the retinal vascular system, including basement membrane thickening, pericyte loss, and terminal arteriole occlusion, usually serve as early signs of the development of diabetic retinopathy (4). In addition to such morphological changes, the flicker light-induced vasodilation of retinal blood vessels is also diminished in diabetic patients (32,33). This diminished response was detected before the clinical appearance of diabetic retinopathy.…”

Section: Neurovascular Interactions In Diabetic Retinasmentioning

confidence: 89%

Neurovascular Interactions in the Retina: Physiological and Pathological Roles

et al. 2013

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Abstract. Increasing evidence suggests that the complex interactions among multiple cell types including neuronal, glial, and vascular cells, are critical for maintaining adequate cerebral blood flow that is necessary for normal brain function and survival. The disturbance of these interactions contributes to the pathogenesis of central nervous system disorders such as stroke and Alzheimer's disease. The retina is part of the central nervous system, and the properties of vasculature in the retina are similar to those in the brain. The interactions among multiple cell types in the retina also play an important role in the maintenance of tissue homeostasis, and the impairment of interactions can contribute to the onset and/or progression of retinal diseases. In this review, we describe the neurovascular interactions in the retina and alternations of interactions in pathological conditions such as diabetic retinopathy and glaucoma.

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Reduced response of retinal vessel diameters to flicker stimulation in patients with diabetes

Cited by 202 publications

References 25 publications

Influence of Flickering Light on the Retinal Vessels in Diabetic Patients

Influence of Flickering Light on the Retinal Vessels in Diabetic Patients

Pilot Study for the Evaluation of Morphological and Functional Changes in Retinal Blood Flow in Patients with Insulin Resistance and/or Type 2 Diabetes Mellitus

Neurovascular Interactions in the Retina: Physiological and Pathological Roles

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