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J.T. Lane, S. Fan, A. Thompson, J. Stoner, E. Margalit, C.B. Toris; Aqueous Flow Rate in the Eye Is Decreased in Patients With Type 1 Diabetes and Microvascular Complications . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3676.
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Purpose:Previously, we showed that patients with type 1 diabetes (DM1) without microvascular complications had decreased aqueous flow rates, compared to non–diabetic controls. The current study investigates whether aqueous flow reduction is similarly associated with acquired microvascular complications in DM1. Methods:8 DM1 patients [4M/4F, age 39±5y (mean±SEM), BMI 24.6±0.8 kg/m2, HbA1C 8.8±0.6%] with retinopathy, microalbuminuria, but no laser or ocular surgery and 7 healthy non–diabetic controls (4M/3F, age 33±3y, BMI 23.9±0.8 kg/m2, HbA1C 5.1±0.1%) were studied. After a screening eye exam, measurements were made during the performance of a hyperinsulinemic–euglycemic glucose clamp (insulin infusion rate 2mU/kg/min) in order to standardize insulin and glucose levels in all subjects. Measurements included aqueous flow (Fa) by fluorophotometry, intraocular pressure (IOP) by pneuomatonometry, outflow facility by pneumatonography, and pulsatile ocular blood flow by Langham tonometer. The DM1 group was compared with the control group with a two–tailed t–test. Values are the mean of both eyes ±SEM. Results:DM1 patients had decreased Fa, compared to controls (2.50±0.24 µl/min v 3.24±0.25 µl/min, respectively, p=0.05) and IOP (22.2±0.6 mmHg v 20.1±0.6 mmHg, p=0.03). There was no difference in pulsatile ocular blood flow or outflow facility between groups. Conclusions:Patients with DM1 and microvascular complications have reduced aqueous flow similar to DM1 patients without complications. A decrease in uveoscleral outflow and/or an increase in episcleral venous pressure would be needed to account for the increase in IOP.
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