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Effect of morphological abnormalities on blood retinal barrier permeability in diabetic retinopathy

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Abstract

The morphological base for the impaired function of the blood retinal barrier was studied in 50 eyes of 10 insulin dependent and 21 non-insulin dependent patients with various levels of diabetic retinopathy. The permeability of the blood retinal barrier (PBRB) was determined by vitreous fluorophotometry with correction for autofluorescence, lenstransmission and non-protein bound plasma fluorescein concentration. Morphological abnormalities of diabetic retinopathy assessed by fundus photography and fluorescein angiography were individually scored on a decimal scale and related to the PBRB by multiple regression analysis. The Pbrb was not correlated to morphological abnormalities of non-proliferative retinopathy [(1) microaneurysms, (2) hard exudates, (3) soft exudates, (4) intraretinal hemorrhages, (5) fluorescein leakage, and (6) capillary closure, p > 0.3]. The PBRB was correlated to morphological abnormalities of (pre)proliferative retinopathy [(1) intraretinal microvascular abnormalities (Sirma) and (2) new vessels (Sneo): pbrb = A − B.SIRMA − C.Sneo with PBRB in nm/sec, A = 1.5 ± 0.5, B = 0.9 ± 0.2 and C = 1.7 ± 0.4, R2 = 0.65, p < 0.0001]. It can be concluded that the increased blood retinal barrier permeability in diabetic patients is mainly due to (pre)proliferative abnormalities and not to non-proliferative abnormalities.

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Authors and Affiliations

  1. Department of Endocrinology & Metabolic Diseases, University Hospital, Leiden, The Netherlands

    Johannes M. A. Van Gerven & Herman H. P. J. Lemkes

  2. Department of Ophthalmology, University Hospital, Leiden, The Netherlands

    Johan P. Boot & Jaap A. Van Best PhD

Authors
  1. Johannes M. A. Van Gerven
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  2. Johan P. Boot
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  3. Herman H. P. J. Lemkes
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  4. Jaap A. Van Best PhD
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Van Gerven, J.M.A., Boot, J.P., Lemkes, H.H.P.J. et al. Effect of morphological abnormalities on blood retinal barrier permeability in diabetic retinopathy. Doc Ophthalmol 80, 183–188 (1992). https://doi.org/10.1007/BF00161244

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