Red Blood Cell Deformability Index in Diabetic Retinopathy

Abstract

In order to investigate the relationship between haemorheological disturbances and diabetic microangiopathy we have studied the red blood cell deformability index (RBCD-index) by means of a filtration technique in 69 diabetics, aged 49-83 years, and in 40 non diabetic healthy controls (group A) of respective age and sex. The diabetics were classified into the following groups, according to the findings of a thorough clinical and laboratory investigation. Twenty patients (group B) were free of vascular complications, whereas 9 (group C) suffered from background retinopathy, 27 (group D) background retinopathy and ischaemic cardiopathy or peripheral arterial occlusive disease and 13 (group E) of proliferative retinopathy with diffuse micro- and macroangiopathy. The RBCD-index was significantly (P less than 0.001) decreased in diabetics with retinopathy compared to the diabetic and non diabetic controls. The lowest RBCD-index was observed in diabetics with proliferative retinopathy and in those with diffuse micro- and macrovascular complications (RBCD-index, means +/- SDM ml/min: A 0.68 +/- 0.15; B 0.64 +/- 0.08; C 0.60 +/- 0.08; D 0.49 +/- 0.09; E 0.48 +/- 0.09). These findings suggest that the RBCD is impaired in diabetics with retinopathy, especially in those with severe vascular complications, and that this abnormal rheological behavior of erythrocytes can be found even in the early stages of diabetic microangiopathy.

Impaired Erythrocyte Deformability Precedes Vascular Changes in Experimental Diabetes Mellitus

“…Thus, it can be postulated that rheological disturbances, such as reduced RBC-df, precede the manifestation of diabetic angiopathy, both micro-and macroangiopathy, and possibly contribute to its pathogenesis in diabetes with bcell insufficiency. This in turn reinforces the ªhemodynamic hypothesisº of the pathogenesis of diabetic microangiopathy, according to which the hemodynamic and rheological disturbances account for the evolution of microangiopathy [9,40]. Sustained hemodynamic actions on the microvasculature directly injure the capillary wall, enhance permeability to macromolecules and promote capillary wall proliferation and basal membrane thickening.…”

The Correlation Between Red Cell Distribution Width and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus

“…19 The relationship between NLR as another inflammation marker and DR had shown. 20 Platelet-to-lymphocyte ratio, monocyteto-lymphocyte ratio, NLR and mean platelet volume are novel potential markers of inflammatory responses. They are significantly increased in the setting of DR. 21 In our study, NLR value was significantly higher in DR (+) group, but it was not significant according to multivariate analysis results.…”

Altered red blood cell deformability—A novel hypothesis for retinal microangiopathy in diabetic retinopathy

“…Impaired RBC deformability leads to disrupted perfusion at tissue level, and this is well documented in diseases that primarily affect RBCs (eg, malaria, 17 sickle cells anemia, 18 and hereditary RBC membrane disorders 19 ). Studies on RBC deformability in DR patients are sparse in current literature despite the prevalence of DM and DR. A few reports have shown reduced RBC deformability in DR patient but their methodology varied and some of the techniques were labor intensive and difficult to replicate 20‐24 . This necessitates the use of simpler and higher‐throughput systems in order to collect larger sample sizes for more conclusive outcomes.…”