Localised blood-retinal barrier leakage and retinal light sensitivity in diabetic retinopathy.

Bek, T.; Lund‐Andersen, Henrik

doi:10.1136/bjo.74.7.388

Cited by 38 publications

(20 citation statements)

References 5 publications

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“…Some investigators found that cotton-wool spots are associated with localised scotoma in visual field, which may persist or disappear in the phase of resolving of cotton-wool spots over time. [21][22][23] We found no publications on visual field loss in hypertensive patients. Unfortunately, fluorescein angiography was not performed in our HD patients.…”

Section: Discussionmentioning

confidence: 62%

Retinal light sensitivity in haemodialysis patients

Pahor¹

2003

Eye

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Purpose The aim of the present study was to compare retinal light sensitivity between normal healthy subjects and chronic renal failure patients treated with maintenance haemodialysis (HD), as well as to determine whether there is a correlation between visual field loss and the age of HD patients, duration of HD treatment and hypertensive retinopathy in HD patients. Methods A total of 50 eyes of 25 HD patients (16 male, nine female) and 30 eyes of 15 controls underwent visual field testing on the C 30-2 program of the Humphrey field analyser. Results Significant reduction in retinal light sensitivity with mean deviation (MD) P values less than 5% was found in 36% (18 eyes), pattern standard deviation (PSD) P values less than 5% in 16 eyes (32%) and corrected pattern standard deviation (CPSD) P values less than 5% in 16 eyes (32%) of HD patients. In control group, all MD, PSD, and CPSD P values were within normal limits. No correlation between reduction of retinal light sensitivity and age or duration of dialysis treatment was observed in HD patients. The reduction of retinal light sensitivity was significantly greater in HD patients with hypertensive retinopathy. Conclusion In 36% of eyes from our HD patients without ophthalmoscopically evident arteriolar occlusion on fundus examination, a significant reduction in retinal light sensitivity was observed. The reduction was significantly greater in HD patients with hypertensive retinopathy.

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Section: Discussionmentioning

confidence: 62%

Retinal light sensitivity in haemodialysis patients

Pahor¹

2003

Eye

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“…Some authors concluded on the basis of the techniques used, that vascular alterations in the diabetic retina were an earlier event than neurosensory dysfunction [52,53]. However, in diabetic animals some authors found evidence that the disease affects retinal metabolism independently from vascular disease [54,55].…”

Section: Discussionmentioning

confidence: 99%

Presence and further development of retinal dysfunction after 3-year follow up in IDDM patients without angiographically documented vasculopathy

et al. 1994

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Summary Abnormalities in neuroretinal function may play a role in the development of diabetic retinopathy. The natural course of diabetic retinal dysfunction in a group of subjects with insulin-dependent diabetes mellitus and with no apparent microvascular alterations in the retina was followed-up with fluorescein angiography and a sensitive electrophysiological technique, i.e., steady-state focal electroretinogram at the macula, for 3 years. Before the beginning and throughout our study, strict glycaemic control was maintained by three or four daily insulin injections under careful monitoring. Analysis of macular electroretinogram provided information from different neural layers. At the first examination, functional activities of postreceptoral neurons were significantly decreased with respect to those of age-matched control subjects. Diabetic patients showed a functional loss of both ganglion cell (0.53 +0.09 vs 0.42 + 0.11 ~tV; t = 5; p = 0.0001) and preganglion cell (0.51 _+ 0.13 vs 0.42 + 0.14 ~tV; t = 2.8; p = 0.007) layers. Diabetes did not alter photoreceptor activity. After 3 years, dysfunction was significantly greater in the preganglion cell layer (0.28 + 0.11 ~tV; t = 6.3; p = 0.0001). Although in some patients further impairment of ganglion cell function was shown, no significant difference was found in 3 years. Photoreceptor function remained unaltered. No vascular abnormalities in the retina were noted after 3 years in this group of patients. Metabolic control was not correlated to functional changes. Our findings suggest that the middle retinal layer is the most sensitive physiological locus of progressive diabetes-induced dysfunction in the absence of angiographically documented abnormalities. [Diabetologia (1994) 37: 911-916] Key words Retinal function, focal electroretinogram, inner retina, photoreceptors, intensive insulin therapy, diabetic retinopathy, follow-up.The sequence of early retinal changes in diabetes is poorly defined. Clinically detectable retinopathy in subjects with IDDM develops many years after the onset of the disease. Diabetic retinopathy has traditionally been attributed to microvascular changes [1]. Little attention has been directed to the effects of diabetes on the neural retina comprised of differReceived: 27 December 1993 and in revised form: 4 April 1994Corresponding author: Professor G. Ghirlanda, Universit~t Cattolica del Sacro Cuore, Istituto di Clinica Medica, Largo A. Gemelli 8, 1-00168 Rome, ItalyAbbreviations: IDDM, insulin-dependent diabetes mellitus; ERG, electroretinogram. ent cell layers and of the optic visual pathway. An important question is whether the mechanisms underlying the disturbances of the diabetic retina may or may not affect retinal neurons earlier than the vessels of the microcirculation. It is presumed that the initial pathological changes which occur in the small vessels of the diabetic retina include endothelial cell and pericyte damage as a result of trypsin digest techniques [2,3] and the breakdown of the blood-retinal barrier detec...

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“…Bek and Lund-Andersen [17] demonstrated that hard exudates often, but not consistently, caused localized scotomata when arranged in dense conglomerates. Khosla et al [18] showed that contrast sensitivity was signifi cantly lower in the diabetic eyes with retinopathy than in the normal eyes or the diabetic eyes without retinopathy.…”

Section: Discussionmentioning

confidence: 99%

Menstrual Cycle-Dependent Changes in White-on-White Visual Field Analysis of Diabetic Women

Akar¹,

Apaydin

Taşkın³

et al. 2005

Gynecol Obstet Invest

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Aim: To determine the effect of the menstrual cycle on white-on-white perimetry (WWP) tests of diabetic women. Subjects and Methods: Left eyes of 129 normally menstruating women (81 type 1 diabetes mellitus (DM) with mild (n = 43) and severe (n = 38) non-proliferative diabetic retinopathy (NPDR), and 48 healthy control females) were included in the study. All subjects underwent complete ocular examination and WWP tests both in the follicular (7–10th day of the cycle) and luteal phases (days 3–7 before the bleeding) of two consecutive menstrual cycles. WWP was performed using Humphrey Field Analyzer II with SITA Standard, central 30-2 program. Mean sensitivity (MS) of points located at central 3, 9, 15, 21 and 27° retinal locations (4, 12, 18, 24 and 16 points, respectively) were calculated in all menstrual phases. Results: The mean age of diabetic patients with mild and severe NPDR and control subjects were 28.8 ± 4.7, 30.1 ± 5.9 and 29.4 ± 5.1 years, respectively (p > 0.05). Their mean MS values were 30.7 ± 1.0, 30.4 ± 1.0 and 30.8 ± 0.8 dB, respectively (p > 0.05). Diabetic patients with severe NPDR demonstrated significant decreases in mean MS values of peripheral 21 and 27° visual field locations in the luteal phase (p < 0.05). However, changes in that of the locations within central 15° visual field were non-significant (p > 0.05). Diabetic patients with mild NPDR and control subjects demonstrated no significant changes in mean MS values of any of the visual field locations (p > 0.05). Conclusion: Peripheral, rather than central, locations of central visual field of diabetic women with severe NPDR demonstrated a significant retinal sensitivity loss in the luteal phase. These findings should be taken into consideration during the clinical follow-up of diabetic women at risk of glaucoma and ocular hypertension.

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Localised blood-retinal barrier leakage and retinal light sensitivity in diabetic retinopathy.

Cited by 38 publications

References 5 publications

Retinal light sensitivity in haemodialysis patients

Retinal light sensitivity in haemodialysis patients

Presence and further development of retinal dysfunction after 3-year follow up in IDDM patients without angiographically documented vasculopathy

Menstrual Cycle-Dependent Changes in White-on-White Visual Field Analysis of Diabetic Women

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