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K. E. Kotliar, A. Schmidt-Trucksaess, T. Siegmund, D. Sitnikova, M. Halle, I. Lanzl; Functional and Morphologic Microstructural Changes of Retinal Artery Blood Column Measured in-vivo in Diabetes Mellitus Type 1. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1331.
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We demonstrated previously that roughness of the retinal artery blood column measured along the vessel axis and termed longitudinal arterial vessel profile (LAP) increases significantly in anamnestically healthy volunteers with increasing age and in glaucoma patients during vasodilation. Whether LAP is altered in diabetes mellitus type 1 (DM1) is investigated.
33 untreated patients with DM1 (age 51.7±8.3 years) with no or non-proliferative retinopathy and 33 age and sex matched medically healthy volunteers were examined by Dynamic Vessel Analyzer (DVA, IMEDOS, Jena, Germany) using stimulation with flickering light. Retinal arterial diameters were measured along 1 mm vessel segments to obtain LAP. DM1 was characterized by the attributes: age, retinopathy, systemic hypertension, duration of disease, duration of insulin therapy. Pairs of subgroups with presence/absence or strongest/poorest manifestation of an attribute were formed. Differences were analyzed using Fourier transformation.
In the whole group LAPs did not differ between DM1 and controls from constriction to dilation of arteries (p>0,2). During arterial reaction LAPs of older DM1 patients possess more high frequency roughness (one oscillation in 63÷179 µm) than young patients. LAPs of young patients show less high frequency roughness during dilation than LAPs of young volunteers. LAPs of patients without retinopathy possess more mid frequency roughness than LAPs of patients with retinopathy and show less mid frequency roughness (one oscillation in 250÷416 µm) during constriction and dilation than LAPs of volunteers.
This non-invasive in-vivo method shows functional and morphological alterations in the retinal vasculature in DM1. Age and retinopathy related microstructural changes in the retinal artery blood column in diabetes might be an indication for alterations in vessel wall rigidity, vascular endothelium and smooth muscle cells in this disease, leading to impaired perfusion and regulation.
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