Role of Blood Flow and Impaired Autoregulation in the Pathogenesis of Diabetic Retinopathy

Kohner, Eva M.; Patel, Vinod; Rassam, S M B

doi:10.2337/diab.44.6.603

Cited by 264 publications

(204 citation statements)

References 29 publications

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“…Increased inflammatory activity has been shown to stimulate leucocytes to adhere to retinal endothelial cells [30], which causes leucostasis and temporary ischaemia upstream of the adhering leucocytes. Reperfusion may damage the endothelium due to the generation of oxidative stress [31], setting the stage for a vicious cycle of endothelial dysfunction, ischaemia and reperfusion. Alternatively, inflammation may reduce endothelial production of nitric oxide [14].…”

Section: Discussionmentioning

confidence: 99%

Markers of inflammation are cross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes?the EURODIAB Prospective Complications Study

et al. 2005

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Aims/hypothesis: The pathogenesis of vascular complications in type 1 diabetes is poorly understood, but may involve chronic, low-grade inflammation. We investigated the association of markers of inflammation with vascular complications in type 1 diabetes. Methods: A cross-sectional nested case-control study of the follow-up data of the EURODIAB Prospective Complications Study. This study included 543 individuals (278 men) with type 1 diabetes diagnosed at <36 years of age. Cases (n=348) had complications of diabetes, controls (n=195) had no complications. Results: C-reactive protein, interleukin-6 and tumour necrosis factor-α levels, which were combined in an inflammatory marker Z-score, were associated with albuminuria, retinopathy and cardiovascular disease. Conclusions/interpretation:We have shown that markers of inflammation are strongly and independently associated with microvascular complications and cardiovascular disease in type 1 diabetes. These data suggest that strategies to decrease inflammatory activity may help to prevent the development of vascular complications in type 1 diabetes.

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Section: Discussionmentioning

confidence: 99%

Markers of inflammation are cross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes?the EURODIAB Prospective Complications Study

et al. 2005

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“…[11][12][13] Hence, even small hypertensioninduced changes in ocular blood flow may put the patient at additional risk for progression of diabetic retinopathy. It has been hypothesized that these small elevations in ocular perfusion may cause endothelial damage and dysfunction, 14 which is observed in patients with type 1 diabetes at the level of the ocular blood vessels. 15 In the present study we focused on young male subjects, because ocular blood flow declines with increasing age [16][17][18] and little information on sex differences in ocular blood flow is available.…”

Section: Discussionmentioning

confidence: 99%

Choroidal blood flow and arterial blood pressure

Polak¹,

Polska²,

Luksch³

et al. 2003

Eye

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Purpose Untreated hypertension is associated with ocular complications and is a risk factor for the development and progression of vascular ocular pathologies. We set out to investigate the association between systemic blood pressure and choroidal blood flow. Methods All subjects were male nonsmokers, who did not receive any medication and had normal or slightly elevated blood pressure (systolic blood pressure r160 mmHg; diastolic blood pressure r100 mmHg). The association between systemic blood pressure and fundus pulsation amplitude, a measure of pulsatile choroidal blood flow, was investigated in 318 volunteers. In addition, the association between systemic blood pressure and blood flow velocities in the posterior ciliary arteries supplying the choroid was investigated in these subjects. Results Ocular fundus pulsation amplitude (r ¼ 0.252; Po0.001) and mean flow velocity in the posterior ciliary arteries (r ¼ 0.346, Po0.001) were significantly associated with mean arterial pressure. The correlation of ocular haemodynamic variables with systolic and diastolic blood pressure was in the same range. Conclusions Our data indicate a small, but significant increase in choroidal blood flow with increasing blood pressure.

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“…Changes in retinal basement membrane extra-cellular matrix proteins, 5 haemodynamic changes, 6 growth factors 7 and cytokines 8 have been implicated.…”

Section: Pathogenesis Of Diabetic Maculopathymentioning

confidence: 99%

The role of serum lipids in exudative diabetic maculopathy: is there a place for lipid lowering therapy?

Chowdhury

Hopkins

Dodson

et al. 2002

Eye

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The treatment for diabetic maculopathy is laser photocoagulation of the pigment epithelium. With the advent of systemic lipid lowering therapy over the last decade, there may be potential for medical therapy also. There is some anecdotal evidence of the effect of lipid lowering agents (particularly statins) in reducing exudate, and a number of studies have shown that lipid lowering therapy may reduce macular exudates, but numbers in these trials are small. A randomised controlled trial is now required to investigate whether the use of systemic lipid lowering therapy is of benefit in patients with exudative maculopathy, even in the absence of dyslipidaemia.

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Role of Blood Flow and Impaired Autoregulation in the Pathogenesis of Diabetic Retinopathy

Cited by 264 publications

References 29 publications

Markers of inflammation are cross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes?the EURODIAB Prospective Complications Study

Markers of inflammation are cross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes?the EURODIAB Prospective Complications Study

Choroidal blood flow and arterial blood pressure

The role of serum lipids in exudative diabetic maculopathy: is there a place for lipid lowering therapy?

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