Retinal Ischemia (Capillary Nonperfusion) in Diabetic Retinopathy of Patients With and Without Systemic Hypertension

1978 ◽  
Vol 177 (2) ◽  
pp. 76-81 ◽  
Author(s):  
S. Merin ◽  
I. Ber ◽  
M. Ivry
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Ischemia ◽  
Systemic Hypertension

scholarly journals Association of changes of retinal vessels diameter with ocular blood flow in eyes with diabetic retinopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshitaka Ueno ◽  
Takeshi Iwase ◽  
Kensuke Goto ◽  
Ryo Tomita ◽  
Eimei Ra ◽  
...  
Keyword(s):  
Blood Flow ◽  
Diabetic Retinopathy ◽  
Adaptive Optics ◽  
Laser Speckle ◽  
The Other ◽  
Systemic Hypertension ◽  
Laser Speckle Flowgraphy ◽  
Retinal Vessels ◽  
External Diameter ◽  
The Mean

AbstractWe investigated morphological changes of retinal arteries to determine their association with the blood flow and systemic variables in type 2 diabetes patients. The patients included 47 non-diabetic retinopathy eyes, 36 mild or moderate nonproliferative diabetic retinopathy (M-NPDR) eyes, 22 severe NPDR (S-NPDR) eyes, 32 PDR eyes, and 24 normal eyes as controls. The mean wall to lumen ratio (WLR) measured by adaptive optics camera was significantly higher in the PDR groups than in all of the other groups (all P < 0.001). However, the external diameter of the retinal vessels was not significantly different among the groups. The mean blur rate (MBR)-vessel determined by laser speckle flowgraphy was significantly lower in the PDR group than in the other groups (P < 0.001). The WLR was correlated with MBR-vessel (r = − 0.337, P < 0.001), duration of disease (r = 0.191, P = 0.042), stage of DM (r = 0.643, P < 0.001), systolic blood pressure (r = 0.166, P < 0.037), and presence of systemic hypertension (r = 0.443, P < 0.001). Multiple regression analysis demonstrated that MBR-vessel (β = − 0.389, P < 0.001), presence of systemic hypertension (β = 0.334, P = 0.001), and LDL (β = 0.199, P = 0.045) were independent factors significantly associated with the WLR. The increased retinal vessel wall thickness led to a narrowing of lumen diameter and a decrease in the blood flow in the PDR group.

Tetrahedral framework nucleic acids prevent retina ischemia-reperfusion injury from oxidative stress via activating the Akt/Nrf2 pathway

Nanoscale ◽  
2019 ◽  
Vol 11 (43) ◽  
pp. 20667-20675 ◽  
Author(s):  
Xin Qin ◽  
Ni Li ◽  
Mei Zhang ◽  
Shiyu Lin ◽  
Junyao Zhu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetic Retinopathy ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Arterial Occlusion ◽  
Retinal Ischemia ◽  
Tetrahedral Framework ◽  
Nrf2 Pathway ◽  
Retinal Arterial Occlusion ◽  
Ophthalmic Diseases

Retinal ischemia-reperfusion (I/R) injuries are involved in the universal pathological processes of many ophthalmic diseases, including glaucoma, diabetic retinopathy, and retinal arterial occlusion.

scholarly journals Lipoperoxides and retinal ischemia in diabetic retinopathy (1)

1978 ◽  
Vol 9 (4) ◽  
pp. 516-520
Author(s):  
Kiyoshi ISHIKAWA ◽  
Masayuki OSHITARI ◽  
Jiro CHIBA ◽  
Yohko SHIMANO
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Ischemia

scholarly journals A Computational Model of Peripheral Photocoagulation for the Prevention of Progressive Diabetic Capillary Occlusion

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Thomas J. Gast ◽  
Xiao Fu ◽  
John Scott Gens ◽  
James A. Glazier
Keyword(s):  
Diabetic Retinopathy ◽  
Computational Model ◽  
Retinal Ischemia ◽  
Peripheral Retina ◽  
Spatial Spread ◽  
Local Feedback ◽  
Ischemic Retina ◽  
Capillary Occlusion ◽  
Local Oxygen ◽  
Retinal Photocoagulation

We developed a computational model of the propagation of retinal ischemia in diabetic retinopathy and analyzed the consequences of various patterns and sizes of burns in peripheral retinal photocoagulation. The model addresses retinal ischemia as a phenomenon of adverse local feedback in which once a capillary is occluded there is an elevated probability of occlusion of adjacent capillaries resulting in enlarging areas of retinal ischemia as is commonly seen clinically. Retinal burns of different sizes and patterns, treated as local oxygen sources, are predicted to have different effects on the propagation of retinal ischemia. The patterns of retinal burns are optimized with regard to minimization of the sum of the photocoagulated retina and computer predicted ischemic retina. Our simulations show that certain patterns of retinal burns are effective at preventing the spatial spread of ischemia by creating oxygenated boundaries across which the ischemia does not propagate. This model makes no statement about current PRP treatment of avascular peripheral retina and notes that the usual spot sizes used in PRP will not prevent ischemic propagation in still vascularized retinal areas. The model seems to show that a properly patterned laser treatment of still vascularized peripheral retina may be able to prevent or at least constrain the propagation of diabetic retinal ischemia in those retinal areas with intact capillaries.

scholarly journals Prevalence, risk factors and awareness of diabetic retinopathy among admitted diabetic patients at a tertiary level hospital in Kathmandu

2014 ◽  
Vol 6 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Raba Thapa ◽  
Deepak Man Joshi ◽  
Aparna Rizyal ◽  
Nhukesh Maharjan ◽  
Rajesh Dhoj Joshi
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Case Series ◽  
Systemic Hypertension ◽  
P Value ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Case Series Study ◽  
Systemic Problems ◽  
Clinically Significant

Introduction: Diabetic retinopathy (DR) is one of the commonest causes of visual impairment and blindness in Nepal. Objectives: The study aims to explore the prevalence, risk factors and awareness of DR among admitted diabetic patients. Materials and methods: A non-interventional case series study was conducted among the inpatient diabetic cases referred for ophthalmic consultation. The patients’ detailed demographics, awareness on DR, concurrent systemic problems, and glycemic control status were recorded. DR was graded using the Early Treatment Diabetic Retinopathy Study Criteria. Main outcome measures: The prevalence, risk factors and awareness of diabetic retinopathy among the study participants was analyzed. Results: A total of 277 diabetic patients were enrolled in the study. The mean age was 62.25 ± 13.26 years. Only one-third (34.6 %) of the cases were admitted for sugar control and newly diagnosed cases comprised of 19.49 %. Nearly half of the cases (46.6 %) were not aware of diabetic retinopathy and dilated fundus evaluation was done for the first time in 44.4 %. DR was found in 38.26 % of the cases and was diagnosed in 13 % of the new cases. Almost four-fifths (78 %) of the diabetics had had the disease for a duration of 16 to 20 years. Clinically significant macular edema was found in 5.78 % and proliferative DR in 2.52 %. DR was significantly associated with the duration of diabetes (P value = 0.001) and concurrent hypertension (P value = 0.004). Conclusion: The prevalence of DR was 38 % among the admitted diabetic cases and the DR was significantly associated with the duration of diabetes and systemic hypertension. Almost half of the cases had been unaware of DR before referral. This emphasizes the importance of the collaboration of the physician and the ophthalmologist for an early DR detection.   DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10760   Nepal J Ophthalmol 2014; 6 (2): 24-30

scholarly journals The pathogenetic substantiation of the use of angiotensin-converting enzyme for the treatment of diabetic retinopathy

2012 ◽  
Vol 58 (5) ◽  
pp. 37-40
Author(s):  
M V Riabina ◽  
N B Chesnokova ◽  
T D Okhotsimskaia ◽  
T P Kuznetsova
Keyword(s):  
Diabetic Retinopathy ◽  
Ace Inhibitor ◽  
Retinal Thickness ◽  
Glycosylated Hemoglobin ◽  
Diabetic Macular Oedema ◽  
Renin Angiotensin System ◽  
Retinal Ischemia ◽  
Angiotensin System ◽  
Before And After ◽  
Ace Activity

The objective of the present work was to study visual functions, as well as changes in the systemic and local renin-angiotensin system before and after intake of the ACE inhibitor perindopril in 65 patients (130 eyes) presenting with diabetic retinopathy. The treatment caused the most pronounced changes in the patients with preproliferative diabetic retinopathy including the two-fold (p<0.05) decrease of ACE activity in the blood and its 7.5-fold (p<0.05) increase in the tears. These effects appear to be attributable to the action of perindopril on the levels of the proangiogenic factors known to be elevated in the patients with severe retinal ischemia. The treatment of patients with diabetic macular oedema with perindopril resulted in the decrease of the retinal thickness from 392.5±46.7 to 347.2±39.6 mcm in the absence of significant improvement in the acuteness of vision. All the patients experienced a significant reduction in the level of glycosylated hemoglobin.

scholarly journals Association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Dorottya Hajdu ◽  
Aleksandra Sedova ◽  
Felix Datlinger ◽  
Julia Hafner ◽  
Irene Steiner ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Disease Duration ◽  
Retinal Ischemia ◽  
Vessel Density ◽  
Statistical Testing ◽  
Foveal Avascular Zone ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
The Mean ◽  
Peripheral Areas

Abstract Background The aim of our study was to investigate a possible association between macular perfusion status and retinal ischemia and leakage up to far peripheral retinal areas in eyes with early to advanced stages of diabetic retinopathy (DR). Methods In a retrospective, cross sectional analysis ultrawide field (UWF) color fundus photos (Optos, Optomap California) were graded for DR severity. Foveal avascular zone (FAZ) and vessel density from the superficial (SCP) and deep capillary plexus (DCP) were assessed on optical coherence tomography angiography (OCTA) scans (Topcon, DRI-OCT Triton). UWF angiography images were used to quantify leakage/ischemic index and number of microaneurysms (MA). Age, gender, disease duration, type of diabetes, HbA1C, hypertension, complications of diabetes and ocular history were recorded. Univariate mixed models and Spearman correlation analysis were used for statistical testing. Results 24 eyes of 17 laser-naive diabetic patients with different stages of DR were analyzed. The mean age was 59.56 ± 8.46 years and the mean disease duration 19.65 ± 12.25 years. No statistically significant associations between FAZ size, macular vessel density of SCP/DCP and peripheral retinal ischemia, leakage and MA number were demonstrated. Higher stages of DR were associated with ischemic index (estimate [95% CI]: 13.04 [1.5; 24.5], p = 0.033) and MA count (estimate [95% CI]: 43.7 [15.6; 71.8], p = 0.01), but no association with leakage index was observed. Only weak correlations between DR severity and anamnestic data were found. Conclusion Retinal ischemic index and the amount of MAs assessed on UWFA up to peripheral areas are indicators of DR severity but not related to microvascular perfusion status in the macular region. Significance and timely sequence of macular vessel density in DR progression may need to be re-evaluated in future studies.

The Assessment of Blood Flow Velocities in Retinal Collaterals in Diabetic Retinopathy

2019 ◽  
Vol 236 (04) ◽  
pp. 530-535
Author(s):  
Gabor Somfai ◽  
Thalmon Campagnoli ◽  
Jing Tian ◽  
Heinrich Gerding ◽  
William Smiddy ◽  
...  
Keyword(s):  
Blood Flow ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Microvascular Disease ◽  
Retinal Ischemia ◽  
Microvascular Changes ◽  
Significant Difference ◽  
Blood Flow Velocities ◽  
Collateral Vessels ◽  
Flow Velocities

Abstract Purpose Diabetic retinopathy (DR) is a microvascular disease characterized by capillary dropout and resultant retinal ischemia which then leads to retinal vascular remodeling. Our goal was to assess blood flow velocities in retinal collateral vessels in healthy and diabetic subjects with various stages of DR. Methods In our pilot study, we enrolled five eyes of five healthy subjects (H), five eyes of four subjects with diabetes and no retinopathy (DM), three eyes of three subjects with mild non-proliferative diabetic retinopathy (MDR), and five eyes of four subjects with proliferative diabetic retinopathy (PDR). Following routine ophthalmic examination, all subjects were imaged using a retinal function imager (RFI; Optical Imaging Inc., Rehovot, Israel). The built-in software of the RFI was used to identify and segment retinal collaterals with measurement of the blood flow velocities (BFV). One-way ANOVA was performed for BFV, followed by Newman-Keuls post hoc test. The level of significance was set at 5%. Results The total number of collateral segments involved in the study was 30, 31, 21, and 39 in the H, DM, MDR, and PDR groups, respectively. The BFVs in the collaterals were significantly lower in PDR (H: 1.86 ± 0.67, DM: 1.91 ± 0.71, MDR: 1.71 ± 0.53, PDR: 1.37 ± 0.58 mm/s). The PDR group showed a statistically significant difference in the comparisons to all groups (p = 0.012, p = 0.008, and p = 0.043 for the H, DM, and MDR groups, respectively), while no other comparisons between the groups were significant. Conclusion We observed decreased BFV in retinal collaterals in PDR that may be due to the extensive capillary dropout and retinal ischemia. Further studies are needed for the noninvasive functional assessment of retinal microvascular changes in DR to better understand the underlying pathophysiology.

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