Interaction between flicker-induced vasodilatation and pressure autoregulation in early retinopathy of Type 2 diabetes
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Diabetic retinopathy is accompanied with changes in the autoregulation of retinal blood flow secondary to changes in the systemic blood pressure and the retinal metabolism. In the present study we tested the working hypothesis that there is an interaction between these mechanisms that might be relevant for understanding and treating flow disturbances in diabetic retinopathy.
Fifty-four persons divided into three age and sex matched groups were studied:
Group 1: twenty normal persons.
Group 2: fourteen patients with type 2 diabetes mellitus and no diabetic retinopathy.
Group 3: twenty type 2 diabetic patients with minimal diabetic retinopathy and a diabetes duration similar to that of the patients in group 2.
The increased blood pressure induced by isometric exercise induced a non-significant vasoconstriction in the normal persons and in the diabetic patients without retinopathy (p = 0.10 and p = 0.84 respectively), and a non-significant vasodilatation in the diabetic patients with mild retinopathy (p = 0.10).
The flicker stimulus elicited a significant vasodilatation of retinal arterioles that decreased significantly from the normal persons to the diabetic patients without and with retinopathy (linear regression, p < 0.01). The flicker-induced vasodilatation was not significantly affected by a simultaneous increase in the arterial blood pressure in normal persons (p = 0.85). Conversely, in the diabetic patients the reduced diameter response during flicker was counteracted by a simultaneous increase in the blood pressure, to a level not differing significantly from the response of normal persons (p = 0.75).
Intervention studies aimed at modifying perfusion in retinal disease should consider the interaction between different mechanisms for autoregulating retinal blood flow. New treatment modalities for retinal vascular disease might need to target several mechanisms of tone control in retinal arterioles simultaneously.
- Jeppesen P, Aalkjaer C, Bek T (2003) Myogenic response in isolated porcine retinal arterioles. Curr Eye Res 27:217–222 CrossRef
- Hessellund A, Aalkjaer C, Bek T (2006) Effect of cyclic guanosine-monophosphate on porcine retinal vasomotion. Acta Ophthalmol Scand 84(2):228–233 CrossRef
- Holmgaard K, Aalkjaer C, Lambert JDC, Bek T (2007) ATP-induced dilation of porcine retinal arterioles depends on the perivascular retinal tissue and acts via an adenosine receptor. Curr Eye Res 32(4):353–359 CrossRef
- Maenhaut N, Boussery K, Delaey C, Van de Voorde J (2007) Control of retinal arterial tone by a paracrine relaxing factor. Microcirculation 14(1):39–48 CrossRef
- Sinclair SH, Grunwald JE, Riva CE, Braunstein SN, Nichols CW, Schwartz SS (1982) Retinal vascular autoregulation in diabetes mellitus. Ophthalmology 89(7):748–750
- Frederiksen CA, Jeppesen P, Knudsen ST, Poulsen PL, Mogensen CE, Bek T (2006) The blood pressure-induced diameter response of retinal arterioles decreases with increasing diabetic maculopathy. Graefes Arch Clin Exp Ophthalmol 244(10):1255–1261 CrossRef
- Blum M, Pils C, Muller UA, Strobel J (2006) The myogenic response of retinal arterioles in diabetic retinopathy. Ophthalmologe 103(3):209–213 CrossRef
- Bursell SE, Clermong AC, Kinsley BT, Simonson DC, Aiello KM, Wolpert HA (1996) Retinal blood flow changes in patients with insulin-dependent diabetes mellitus and no diabetic retinopathy. Invest Ophthalmol Vis Sci 37:886–897
- Trick GL, Edwards P, Desai U, Berkowitz BA (2006) Early supernormal retinal oxygenation response in patients with diabetes. Invest Ophthalmol Vis Sci 47(4):1612–1619 CrossRef
- Rassam SM, Patel V, Chen HC, Kohner EM (1996) Regional retinal blood flow and vascular autoregulation. Eye 10:331–337
- Dorner GT, Garhöfer G, Huemer KH, Riva CE, Wolzt M, Schmetterer L (2003) Hyperglycemia affects flicker-induced vasodilation in the retina of healthy subjects. Vision Res 43(13):1495–1500 CrossRef
- Pournaras JA, Petropoulos IK, Munoz JL, Pournaras CJ (2004) Experimental retinal vein occlusion: effect of acetazolamide and carbogen (95% O2/5% CO2) on preretinal PO2. Invest Ophthalmol Vis Sci 45(10):3669–3677 CrossRef
- Garhöfer G, Zawinka C, Resch H, Kothy P, Schmetterer L, Dorner GT (2004) Reduced response of retinal vessel diameters to flicker stimulation in patients with diabetes. Br J Ophthalmol 88(7):887–891 CrossRef
- Polak K, Schmetterer L, Riva CE (2002) Influence of flicker frequency on flicker-induced changes of retinal vessel diameter. Invest Ophthalmol Vis Sci 43(8):2721–2726
- Garhöfer G, Zawinka C, Resch H, Huemer KH, Dorner GT, Schmetterer L (2004) Diffuse luminance flicker increases blood flow in major retinal arteries and veins. Vision Res 44(8):833–838 CrossRef
- Pache M, Nagel E, Flammer J (2002) Reproducibility of measurements with the Retinal Vessel Analyzer under optimal conditions. Klin Monatsbl Augenheilk 219(7):523–527 CrossRef
- Jeppesen P, Gregersen PA, Bek T (2004) The age-dependent decrease in the myogenic response of retinal arterioles as studied with the Retinal Vessel Analyzer. Graefes Arch Clin Exp Ophthalmol 242(11):914–919 CrossRef
- Dumskyj MJ, Kohner EM (1999) Retinal blood flow regulation in diabetes mellitus: impaired autoregulation and no detectable effect of autonomic neuropathy using laser Doppler velocimetry, computer assisted image analysis, and isometric exercise. Microvasc Res 57(3):353–356 CrossRef
- Garhöfer G, Zawinka C, Huemer KH, Schmetterer L, Dorner GT (2003) Flicker light-induced vasodilatation in the human retina: effect of lactate and changes in the mean arterial pressure. Invest Ophthalmol Vis Sci 44(12):5309–5314 CrossRef
- Shakoor A, Blair NP, Mori M, Shahidi M (2006) Chorioretinal vascular oxygen tension changes in response to light flicker. Invest Ophthalmol Vis Sci 47(11):4962–4965 CrossRef
- Garhöfer G, Resch H, Weigert G, Lung S, Simader C, Schmetterer L (2005) Short-term increase of intraocular pressure does not alter the response of retinal and optic nerve head blood flow to flicker stimulation. Invest Ophthalmol Vis Sci 46(5):1721–1725 CrossRef
- Riva CE, Cranstoun SD, Petrig BL (1996) Effect of decreased ocular perfusion pressure on blood flow and the flicker-induced flow response in the cat optic nerve head. Microvasc Res 52(3):258–269 CrossRef
- Jeppesen P, Knudsen ST, Poulsen PL, Mogensen CE, Schmitz O, Bek T (2007) Response of retinal arteriole diameter to increased blood pressure during acute hyperglycemia. Acta Ophthalmol Scand 85(3):280–286 CrossRef
- Interaction between flicker-induced vasodilatation and pressure autoregulation in early retinopathy of Type 2 diabetes
Graefe's Archive for Clinical and Experimental Ophthalmology
Volume 246, Issue 5 , pp 763-769
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Retinal autoregulation
- Flicker-induced vasodilation
- Diabetic retinopathy
- Retinal Vessel Analyzer
- Industry Sectors