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L.-A. Khuu, O. Puzyeyeva, J. Flanagan, T. Wong, W. C. Lam, S. N. Markowitz, R. Devenyi, M. Brent, M. Mendelcorn, C. Hudson; Systemic Markers of Endothelial Dysfunction / Inflammation and Retinal Vascular Reactivity in Type 2 Diabetes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5065.
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To investigate the association, if any, between retinal vascular reactivity and systemic markers of endothelial dysfunction / vascular inflammation in non-proliferative diabetic retinopathy (NPDR).
The sample consisted of 36 type 2 diabetes patients with NPDR and 10 control subjects (mean age 56.0±11.36yrs). Patients were divided into mild-to-moderate (n=22, 61.1±8.8yrs) and moderate-to-severe (n=14, 61.7±11.2yrs) NPDR. Following pupil dilation, retinal vessel diameter, velocity and blood flow were assessed in the supero-temporal arteriole using the Canon Laser Blood Flowmeter. Retinal vascular reactivity was quantified as the difference in hemodynamic parameters between baseline and hyperoxic provocation. Six measurements were acquired at each phase. Forearm blood samples to derive systemic levels of intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), E-selectin and von Willebrand factor (vWF) were collected. Baseline retinal vascular reactivity was compared between groups and correlated with each systemic marker of endothelial dysfunction / vascular inflammation.
ICAM-1 (ANOVA, p=0.022) and E-selectin (p=0.023) were elevated in patients with diabetes, as was A1c (p<0.002). While vascular reactivity in terms of velocity and blood flow decreased (p<0.001), max:min velocity ratio increased (p<0.004), in response to provocation in all groups. The magnitude of vascular reactivity in terms of retinal blood flow was negatively correlated with VCAM-1 across the two diabetic groups (r=-0.3858, p=0.035), while vascular reactivity in terms of max:min velocity ratio was positively correlated with vWF across all the groups (r=0.3632, p=0.0.035).
Disturbance of vascular reactivity and systemic markers of endothelial dysfunction / vascular inflammation was elevated in patients with NPDR. VWF and VCAM-1 showed marginal associations with vascular reactivity assessment in patients with NPDR.
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