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Retinal blood flow in diabetic children and adolescents

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Abstract

A total of 209 diabetic children and adolescents aged 6–17 years (mean, 12.6 ± 2.3 years) were examined by ophthalmoscopy, video fluorescein angiography and hemoglobin (HbA1c) tests. Microaneurysms were found in 26% of the children (ophthalmoscopy, 11%; angiography, 23%). The prevalence of retinopathy was 16% in patients aged 6–10 years, 27% in those aged 11–13 years and 36% in those aged 14–17 years. Only five diabetics aged 11–17 years showed lesions other than microaneurysms (hard exudates, intraretinal hemorrhages or retinal capillar leakage). Retinal blood flow was quantified using video fluorescein angiography. The arm-retina time (ART) and the arteriovenous passage time (AVP) as parameters of the retinal microcirculation were obtained using an image analysing system. The mean value for ART was 9.7±2.5 s and that for AVP was 1.43±0.52 s. AVP was significantly shorter in diabetic children and adolescents with good glycemic control (HbAlc, <7%; AVP, 1.35±0.44 s) than in those with bad glycemic control (HbA1c, ≥ 9 % ; AVP, 1.65 ±0.51 s).

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References

  1. Apple DJ, Rabb ME (1985) Ocular pathology, 3rd edn. Mosby, St. Louis

    Google Scholar 

  2. Ashton N (1983) Pathogenesis of diabetic retinopathy. In: Little HL, Jack RL, Patz A, Forham PH (eds) Diabetic retinopathy. Thieme-Stratton, New York, pp 85–106

    Google Scholar 

  3. Barta L, Brooser G, Molnar M (1971) Diagnostic value of retinal fluorescence angiography in juvenile diabetes. Acta Paediatr Acad Sci Hung 12:243–245

    Google Scholar 

  4. Bertram B, Wolf S, Elbers M, Joussen W, Reim M (1988) Untersuchung retinaler Kreislaufzeiten bei Patienten mit insulinpflichtigem Diabetes mellitus Typ II. Fortschr Ophthalmol 85:413–415

    Google Scholar 

  5. Blair NP, Feke GT, Morales-Stopello J, Riva CE, Goger DG, Collas G, McMeel W (1982) Prolongation of the retinal mean circulation time in diabetes. Arch Ophthalmol 100:764–768

    Google Scholar 

  6. Brooser G, Barta L, Anda L, Molnar M (1975) Frühdiagnose der Mikroangiopathie bei kindlichem Diabetes. Klin Monatsbl Augenheilkd 166:233–236

    Google Scholar 

  7. Cogan D, Toussaint D, Kuwabara T (1961) Retinal vascular patterns. Arch Ophthalmol 66:366–378

    Google Scholar 

  8. Davis EG, Hyer SL, Kohner EM (1990) Macular blood flow response to acute reduction of plasma glucose in diabetic patients measured by the blue light entoptic technique. Ophthalmology 97:160–164

    Google Scholar 

  9. Davis MD (1988) Diabetic retinopathy: a clinical overview. Diabetes/Metab Rev 4:291–322

    Google Scholar 

  10. DCCT Research Group (1986) The diabetes control and complications trial (DCCT): design and methodologic considerations for the feasibility phase. Diabetes 35:530–545

    Google Scholar 

  11. Fallon TJ, Chowiencyk P, Kohner EM (1986) Measurement of retinal blood flow in diabetes by the blue-light entoptic phenomen. Br J Ophthalmol 70:43–46

    Google Scholar 

  12. Fallon TJ, Maxwell DL, Kohner EM (1987) Autoregulation of retinal blood flow in diabetic retinopathy measured by the blue-light entoptic technique. Ophthalmology 94:1410–1415

    Google Scholar 

  13. Frank RN, Hoffmann WH, Podgor MJ, Joondeph HC, Lewis RA, Margherio RR, Nachazel DP, Weiss H, Christopherson KW, Cronin MA (1982) Retinopathy in juvenile-onset type I diabetes of short duration. Diabetes 31:874–882

    Google Scholar 

  14. Frost-Larsen K, Starup K (1980) Fluorescein angiography in diabetic children: a follow-up. Acta Ophthalmol 58:355–360

    Google Scholar 

  15. Grunwald JE, Riva CE, Stone RA, Keates EU, Petrig BL (1984) Retinal autoregulation in open-angle glaucoma. Ophthalmology 91:1690–1694

    Google Scholar 

  16. Grunwald JE, Riva CR, Sinclair SH, Brucker AJ, Petrig BL (1986) Laser Doppler velocimetry study of retinal circulation in diabetes mellitus. Arch Ophthalmol 104:991–995

    Google Scholar 

  17. Holm S (1979) A simple sequentially rejective multiple test procedure. Scand J Stat 6:65–70

    Google Scholar 

  18. Kiesewetter H, Jung F, Körber N, Wolf S, Kiehl R, Frank M, Reim M, Sitzmann FC, Weinges KF (1986) Microcirculation and hemorheology of children with type I diabetes. Klin Wochenschr 64:962–968

    Google Scholar 

  19. Kingsley R, Ghosh G, Lawson P, Kohner EM (1983) Severe diabetic retinopathy in adolescents. Br J Ophthalmol 67:73–79

    Google Scholar 

  20. Klein R, Klein BEK, Moss SE, Davis MD, DeMets DL (1984) The Wisconsin epidemiologic study of diabetic retinopathy: II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol 102:520–526

    CAS  PubMed  Google Scholar 

  21. Koerner F, Fries K, Niesel P, Dubied P (1978) Zur Interpretation der retinalen Kreislaufzeiten bei der diabetischen Retinopathie vor und nach Photokoagulation. Klin Monatsbl Augenheilkd 172:440–444

    Google Scholar 

  22. Kohner EM, Hamilton AM, Saunders SJ, Sutcliffe BA, Bulpitt CJ (1975) The retinal blood flow in diabetes. Diabetologia 11:27–33

    Google Scholar 

  23. Malone JI, Cader TC, Edwards WC van (1977) Diabetic vascular changes in children. Diabetes 26:673–679

    Google Scholar 

  24. Murphy RP, Nanda M, Plotnick L, Enger C, Vitale S, Patz A (1990) The relationship of puberty to diabetic retinopathy. Arch Ophthalmol 108:215–218

    Google Scholar 

  25. Reim M, Körber N, Wolf S, Jung F (1984) Quantitative Videoangiographie der Retina bei Patienten mit Diabetes mellitus Typ II. In: Kiesewetter H, Ehrly AM, Jung F (eds) Hämorheologische Meßmethoden. Deutsche Gesellschaft für Klinische Hämorheologie e.V. (DGKH), Homburg/Saar, pp 61–64

    Google Scholar 

  26. Sitzmann FC (1984) Untersuchungen zum Erythrozyten-Stoffwechsel bei Diabetes mellitus Typ I (Schlüsselenzyme der Glykolyse). Pädiatr Pädiol 19:303–309

    Google Scholar 

  27. Soeldner JS, Christacopoulos PD, Gleason RE (1976) Mean retinal circulation time as determined by fluorescein angiography in normal prediabetic and chemical-diabetic subjects. Diabetes 252:903–908

    Google Scholar 

  28. Standl E, Janka HU, Lander T, Stiegler H (1985) Diabetische Mikroangiopathie: Risikofaktoren und Möglichkeiten der Präventation durch gute Diabeteseinstellung. Aktuel Endokr Stoffw 6:121–128

    Google Scholar 

  29. Unger HH, Unger J (1967) Retinale Angiolopathie juveniler Diabetiker. Klin Monatsbl Augenheilkd 50:644–654

    Google Scholar 

  30. Valone JA, McMeel JW (1978) Severe adolescent-onset proliferative diabetic retinopathy; the effect of pituitary ablation. Arch Ophthalmol 96:1349–1353

    Google Scholar 

  31. Wolf S, Körber N, Mielke B, Grümmer M, Kiesewetter H, Jung F, Bertram B, Reim M (1987) Videoangiographische Untersuchungen bei juvenilen Diabetikern. Fortschr Ophthalmol 84:607–610

    Google Scholar 

  32. Wolf S, Jung F, Kiesewetter H, Körber N, Reim M (1989) Video fluorescein angiography: method and clinical application. Graefe's Arch Clin Exp Ophthalmol 227:145–151

    Google Scholar 

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Authors and Affiliations

  1. Augenklinik der RWTH Aachen, Pauwelsstrasse 30, W-5100, Aachen, Federal Republic of Germany

    Bernd Bertram, Sebastian Wolf, Karin Schulte & Martin Reim

  2. Abteilung für klinische Hämostaseologie und Transfusionsmedizin, Universität des Saarlandes, W-6650, Homburg, Federal Republic of Germany

    Friedrich Jung & Holger Kiesewetter

  3. Kinderklinik der Universität des Saarlandes, W-6650, Homburg, Federal Republic of Germany

    Friedrich C. Sitzmann

Authors
  1. Bernd Bertram
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  2. Sebastian Wolf
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  3. Karin Schulte
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  4. Friedrich Jung
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  5. Holger Kiesewetter
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  6. Friedrich C. Sitzmann
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  7. Martin Reim
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Additional information

Supported by Deutsche Forschungsgemeinschaft grant 152/25-1. We are most grateful to Dr. Bürger-Büsing (University of Schad), President of the Child and Adolescent Diabetic's Association, for his assistance

Offprint requests: B. Bertram

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Bertram, B., Wolf, S., Schulte, K. et al. Retinal blood flow in diabetic children and adolescents. Graefe's Arch Clin Exp Ophthalmol 229, 336–340 (1991). https://doi.org/10.1007/BF00170691

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  • DOI: https://doi.org/10.1007/BF00170691

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