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K. Guan, C. Hudson, T. Wong, M. Kisilevsky, R.K. Nrusimhadevara, W.C. Lam, R.G. Devenyi, M. Mandelcorn, J.G. Flanagan; Retinal Hemodynamics and Systemic Measures in Stratified Groups of Diabetic Patients at Increasing Risk for the Development of Clinically Significant Diabetic Macular Edema . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4081.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To establish the baseline characteristics of stratified groups of diabetic patients at increasing risk for the development of clinically significant diabetic macular edema (CSDME) in terms of retinal hemodynamic parameters and systemic outcome measures. Methods: Group 1: 49 normal control subjects. Group 2: 61 diabetic patients without retinopathy. Group 3: 45 diabetic patients with micro–aneurysms and / or hard exudates within 2 disc diameters of the fovea. Group 4: 38 patients with non–CSDME. Retinal hemodynamics (diameter, velocity and flow) were assessed in a superior and inferior retinal arteriole using the Canon Laser Blood Flowmeter (CLBF), model 100. Intraocular pressure, blood pressure and standard blood tests were measured. Results: No significant differences were found between groups with respect to diameter, velocity or flow. A linear regression across the diabetic groups showed a significant increase in retinal blood flow corrected for mean arterial pressure with increasing risk for the development of CSDME in the superior temporal arteriole (p=0.048). No significant differences were found between superior and inferior arterioles across all groups. A significant increasing linear trend was noted in the max:min velocity ratio with increasing risk for the development of CSDME (p<0.001). Visual acuity was significantly worse in groups 2 and 3 (p=0.01). All diabetic groups had elevated triglycerides, urinary albumin and urinary albumin:creatinine ratio. In addition, Group 1 had elevated serum urea, Group 2 had elevated serum osmolarity and Group 3 had elevated serum urea and osmolarity. Subjects with diabetes tended to have higher systolic blood pressures. Conclusions: There was a significant increase in the max:min velocity ratio with increasing risk for the development of CSDME. A significant trend was noted for increasing retinal blood flow with increasing risk for development of CSDME.
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