Retinal Capillary Rarefaction in Patients with Type 2 Diabetes Mellitus

Abstract

PurposeIn diabetes mellitus type 2, capillary rarefaction plays a pivotal role in the pathogenesis of end-organ damage. We investigated retinal capillary density in patients with early disease.MethodsThis cross-sectional study compares retinal capillary rarefaction determined by intercapillary distance (ICD) and capillary area (CapA), measured non-invasively and in vivo by scanning laser Doppler flowmetry, in 73 patients with type 2 diabetes, 55 healthy controls and 134 individuals with hypertension stage 1 or 2.ResultsIn diabetic patients, ICD was greater (23.2±5.5 vs 20.2±4.2, p = 0.013) and CapA smaller (1592±595 vs 1821±652, p = 0.019) than in healthy controls after adjustment for differences in cardiovascular risk factors between the groups. Compared to hypertensive patients, diabetic individuals showed no difference in ICD (23.1±5.8, p = 0.781) and CapA (1556±649, p = 0.768).ConclusionIn the early stage of diabetes type 2, patients showed capillary rarefaction compared to healthy individuals.

Retinal capillary rarefaction in patients with untreated mild-moderate hypertension

“… Data are given as mean ± SD, duration of disease, BMI is given as median and interquartile range, BMI body mass index, BP blood pressure, HR heart rate, LDL low density lipids, HDL high density lipids, RCF retinal capillary flow, ICD intercapillary distance, CapA capillary area, OD outer diameter retinal arteriole, ID inner diameter retinal arteriole, WT wall thickness retinal arteriole, WLR wall to lumen ratio, CA cross sectional area The data for the healthy control subjects have been previously described by our study group [ 21 ] …”

“… Data are given as mean ± SD, ICD intercapillary distance, CapA capillary area, RCF retinal capillary flow, adjusted p -value: total hypertensive group versus healthy subjects The data for the healthy control subjects have been previously described by our study group [ 21 ] Model 1 includes: gender, BMI, systolic office BP, serum-creatinine and HDL-cholesterol Model 2 includes: gender, BMI, systolic office BP, serum-creatinine and HDL-cholesterol, age, LDL- cholesterol and ex-smoking habit Model 3 includes: gender, BMI, serum creatinine, HDL-cholesterol, systolic 24 h ambulatory BP …”

“…Thus, baseline data of 55 healthy individuals and 70 short time as well as 64 long time hypertensive patients were included. The healthy reference study population has been previously described by our study group [ 21 ].…”

“…SLDF of retinal vessels allows the investigation of capillary area (CapA), intercapillary distance (ICD) and retinal capillary flow (RCF) based on analysis of perfusion images. One of our previously analyses showed retinal capillary rarefaction in patients with diabetes mellitus type two compared to healthy individuals [ 21 ]. Patients with hypertension have been shown to present similar values of CapA und ICD when compared to patients with diabetes mellitus type two [ 21 ].…”

“…One of our previously analyses showed retinal capillary rarefaction in patients with diabetes mellitus type two compared to healthy individuals [ 21 ]. Patients with hypertension have been shown to present similar values of CapA und ICD when compared to patients with diabetes mellitus type two [ 21 ]. Increasing duration of hypertension has been previously shown to be associated with a deterioration of postocclusive hyperemia [ 22 ].…”