title: Effect of morphological abnormalities on blood retinal barrier permeability in diabetic retinopathy.
abstract: The morphological base for the impaired function of the blood retinal barrier was studied in 50 eyes of 10 insulin dependent and 21 non-insulin dependent patients with various levels of diabetic retinopathy. The permeability of the blood retinal barrier (PBRB) was determined by vitreous fluorophotometry with correction for autofluorescence, lens transmission and non-protein bound plasma fluorescein concentration. Morphological abnormalities of diabetic retinopathy assessed by fundus photography and fluorescein angiography were individually scored on a decimal scale and related to the PBRB by multiple regression analysis. The PBRB was not correlated to morphological abnormalities of non-proliferative retinopathy [(1) microaneurysms, (2) hard exudates, (3) soft exudates, (4) intraretinal hemorrhages, (5) fluorescein leakage, and (6) capillary closure, p greater than 0.3]. The PBRB was correlated to morphological abnormalities of (pre)proliferative retinopathy [(1) intraretinal microvascular abnormalities (SIRMA) and (2) new vessels (Sneo): PBRB = A+B.SIRMA + C.Sneo with PBRB in nm/sec, A = 1.5 +/- 0.5, B = 0.9 +/- 0.2 and C = 1.7 +/- 0.4, R2 = 0.65, p less than 0.0001]. It can be concluded that the increased blood retinal barrier permeability in diabetic patients is mainly due to (pre)proliferative abnormalities and not to non-proliferative abnormalities.
authors.affiliation: Department of Endocrinology & Metabolic Diseases, University Hospital, Leiden, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: van Gerven
authors.forename: J P
authors.initials: JP
authors.lastname: Boot
authors.forename: H H
authors.initials: HH
authors.lastname: Lemkes
authors.forename: J A
authors.initials: JA
authors.lastname: van Best
mesh_terms: D001813:Blood-Retinal Barrier; D002199:Capillary Permeability; D003930:Diabetic Retinopathy / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D015590:Fluorophotometry; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography