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C.Q. Panzan, D. Verma, D. Yanai, J.V. Rossi, G.Y. Fujii, D. Dave, C. Walton; Role of Perfusion Pressure in the Pathogenesis and Severity of Diabetic Retinopathy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3957.
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Purpose: To ascertain the role of perfusion pressure in the pathogenesis and severity of Diabetic Retinopathy (DR). Methods: 55 eyes of 29 patients (15 males and 14 females) with non-insulin dependent diabetes mellitus (NIDDM) were examined and divided into two groups according to the stage of diabetic retinopathy: (a) mild to moderate non-proliferative diabetic retinopathy (NPDR), n=42 eyes and (b) proliferative diabetic retinopathy (PDR), n=13 (3 eyes of the total of 58 eyes were excluded from this study because the amplitude of perfusion pressure and the ocular blood flow could not be measured - 2 with NPDR and 1 with PDR).These patients underwent measurements of systemic blood pressure, intra ocular pressure and ocular blood flow , using ocular blood flow meter (OBF Labs ,UK). Average perfusion pressure (AvPP) and amplitude of perfusion pressure (AmPP) were calculated. Results: There was a statistically significant increased mean AmPP in eyes with NPDR compared to those with PDR (mean 16.4 vs 14.4, p = 0.034 using Student’s t test). There was also a statistically significant increased mean AvPP in the NPDR group, when compared to the PDR group (mean 3.2 vs 2.5, p = 0.050 using Student’s t test). The ocular blood flow was also found to be higher in the NPDR group compared to PDR, although this difference was not significant (mean 15.4 vs 14.8, p = 0.739 using Student’s t test). The level of correlation of the examined variables, AmPP and AvPP, with respect to the severity of diabetic retinopathy was determined by an Odds ratio (0.7479 vs. 0.3519 applying the logistic regression with "Stepwise" method). Conclusions: Amplitude of perfusion pressure and average of perfusion pressure may be involved in the pathogenesis and severity of the diabetic retinopathy. Even though both variables had its importance, amplitude of perfusion pressure had a higher correlation with DR severity (odds ratio value) in the NIDDM group.
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